Workload and psychosocial risks among nurses in mental health and psychiatry in Chile.

The present study aims to explore and compare psychosocial risks and work overload among nursing professionals in the field mental health and psychiatry in Chile. Quantitative, observational and cross-sectional research was designed for this purpose. Nurses from community, ambulatory, hospital and emergency units in mental health and psychiatry in Chile were recruited between January and May 2022. Instruments of psychosocial variables and an occupational psychosocial risk scale based on the Copenhagen Psychosocial Questionnaire were used. Descriptive and correlational statistics were used, as well as independent samples t-tests, Factorial Anova and post-hoc analysis with Bonferroni correction. As a result, 174 nursing professionals were recruited, 79.3% female, average age 33.9 years. One-third belonged to the Metropolitan Region of Chile. The highest psychosocial risk was obtained by nurses over 30 years of age, from the Metropolitan Region, with more than 16 patients under their care, at the hospital or psychiatric emergency level. Significant differences were observed in work overload and psychosocial risks according to personal and work characteristics of the professionals, as well as of the users and health services. The levels of psychosocial risk and work overload of mental health and psychiatric nurses were reported, as well as the comparison of these according to personal, sociodemographic, and work characteristics. In order to improve the quality of work life of these professionals and the quality of these services, it is essential to develop interventions focused on the dimensions addressed, as well as to define norms and policies that ensure a workload in accordance with international standards.

Reducing Stigma Toward People with Serious Mental Illness Through a Virtual Reality Intervention: A Randomized Controlled Trial.

Background: Stigma toward people with serious mental illnesses (SMI), like schizophrenia, is a serious global public health challenge that limits the quality of life of those affected and poses a major barrier that keeps people from seeking professional help. There is an urgent need for novel, effective, and scalable interventions to decrease stigmatized perceptions of chronic psychotic disorders and to reduce the health burden imposed by them. Method: We conducted a randomized controlled trial to assess the impact of a new immersive virtual reality game (Inclúyete-VR) on the level of stigma toward people with SMI, measured by the Attribution questionnaire (AQ-27). Participants in the experimental group were exposed in an immersive way to hallucinations common in schizophrenia, then shown different psychosocial resources available for their recovery and social inclusion; those in the control group used VR software unrelated to mental health. VR sessions were delivered through Oculus headgear and lasted 25 minutes. Results: We randomly assigned 124 university students (55% female) to experimental or control conditions (n = 62 each). We used mixed ANOVA to compare outcomes before and after the intervention between the two groups. We found a significant intervention-by-time interaction (P < 0.001), with a reduction in the experimental group of overall stigma levels on the AQ-27 scale and its three subscales: dangerousness-fear, avoidance, and lack of solidarity (P < 0.001 for all). Conclusions: The Inclúyete-VR software proved effective in the short term in reducing stigma toward people with severe mental illness. The program's longer-term efficacy, scalability, and dissemination remain to be studied. ClinicalTrials.gov Identifier: NCT05393596.

Wellbeing, social media addiction and coping strategies among Chilean adolescents during the pandemic.

Introduction: During the COVID-19 pandemic, adolescents had to deal with a range of mental health problems that has increased social media addiction levels with adverse effects on life satisfaction. Previous studies have explored coping mechanisms to deal with this addiction problem, but did not consider the need to simultaneously cope with different dimensions. Therefore, our study aimed to examine the moderating effect of various coping mechanisms on the relationship between social media addiction and adolescent life satisfaction. Methods: Self-report questionnaires were applied to 1290 secondary school students (age mean = 16.03, SD = 1.27, range: 14 to 19; and 57% female). An exploratory and a confirmatory factor analysis were performed to determine the factor structure of the Brief-Cope 28 scale. Then, a descriptive and correlational analysis of the variables and a multiple linear regression analysis was performed. Results: We found that the social media addiction risk was negatively associated with life satisfaction, adaptive strategies were positively correlated to life satisfaction, and maladaptive strategies were negatively correlated to it. Also, a moderation model was evaluated in which four stress management strategies, namely acceptance and perspective-taking, seeking socio-emotional support, active coping, and maladaptive strategies all conditioned the relationship between social media addiction risk and life satisfaction after controlling for demographic variables and the specific strategies of using comedy, religion and substance use. Results indicate additive and multiplicative effects of management strategies for stressful situations in the studied relationship. Seeking socio-emotional support and active coping were positively related to life satisfaction and maladaptive strategies were negatively associated with it. Multiplicative effects indicate that the relationship between the social media addiction risk and life satisfaction depends only on the acceptance and perspective taking that adolescents report. When adolescents reported having low or average levels of acceptance and perspective taking, there was a negative correlation with general life satisfaction, a connection that grew markedly stronger. In contrast, no connection between social media addiction and life satisfaction was detected for adolescents who report higher levels of acceptance and perspective-taking. Discussion: Abuse of social media and the use of maladaptive stress coping strategies were risk factors that decreased life satisfaction among adolescents during the COVID-19 pandemic period.

Measuring school social climate in Latin America: the need for multidimensional and multi-informant tests - A systematic review.

Introduction: School social climate is central to understanding learning experiences in education environments. Previous studies describe various conceptual and operational definitions around the construct; however, there are no records of reviews focused on Latin America. Aim: This study sought to analyze the available evidence and the quality of school social climate measures in Latin America through a systematic review of the literature based on the PRISMA methodology and the COSMIN checklist to assess the psychometric properties of the instruments. Methodology: The Web of Science, Scopus, Psycinfo, and SciELO databases were consulted. A total of 582 records was identified, of which 27 fulfilled the inclusion criteria and methodological quality to be included in the systematization. Results: The results show that the country with the greatest scientific production on the topic is Chile, the measures are centered mainly on the students' perspective and the most used instrument is the CECSCE. In addition, a common aspect to all the records is that they were not sufficient to capture the complexity of school social climate. Conclusion: Multidimensional and multi-informant measures are needed to adequately assess the construct.

The negative association of perceived stress with adolescents' life satisfaction during the pandemic period: The moderating role of school community support.

Purpose: To analyze the association of perceived stress on the life satisfaction of Chilean adolescents during the recent pandemic, and to evaluate the moderating role that school community support provides. Methods: A total of 1337 adolescents in Chile (56.6% females), aged 14 through 19 (M = 15.99; SD = 1.3) participated. Descriptive statistics, a multiple linear regression model, and moderation analysis were all employed. Results: Females were associated with lower levels of Life Satisfaction (B = -0.19, p = .042), which was not the case for the Age variable (p = .160). The level of Perceived Stress was shown to have a negative association on Life Satisfaction (B = -1.93, p < .001). The moderation analysis revealed an interaction factor between Perceived Stress and School Community Support as predictors of Life Satisfaction (B = 0.37, t = 4.91, p < .001), showing that higher levels of School Community Support moderated the negative effect of Perceived Stress on Life Satisfaction. Conclusions: Perceived stress during the pandemic had a negative association on life satisfaction. School community support was a protective factor for this negative effect, even in the case of online classes due to school closures. Strengthening the connection between adolescents and their school communities along with providing additional tools and resources in support of such a connection are both essential.

Perceptions of professionals about factors affecting the implementation of early childhood support systems: A case study evaluation from an ecological perspective.

This evaluation research looked at factors affecting collaboration across the various levels of implementation of early childhood support systems. An ecological conceptual framework was used to examine barriers and facilitators to implementing social and health care services from the perspective of the professionals involved at the national, state, and local level of government. A single case study following a qualitative research strategy was conducted with a total of 29 professionals from social development and health ministries, one municipality and a family health center responsible for implementing the Chile Grows with You system. The results show that at the national level, the main factors include socio-political aspects, funding, and the empathy that professional employees hold for peers who are at lower rungs in the hierarchy. At the state level workplace conditions play a key role. For the local level those factors include information system management and the political support of the local government. The discussion section emphasizes the relevance of considering the interdependence of such factors that influence implementation outcomes and the need to move away from a single program evaluation to a multilevel implementation analysis of public policy.

Satisfacción usuaria en psiquiatría: niveles y factores asociados / User satisfaction in psychiatry: levels and associated factors

Objetivo principal: Determinar los niveles de satisfacción usuaria y sus factores asociados, en una unidad hospitalaria psiquiátrica en Chile. Metodología: Participaron 479 personas, con un promedio de 37,5 años (44,9% mujeres). Se utilizó estadística descriptiva y un modelo de regresión lineal múltiple. Resultados principales: El promedio de satisfacción usuaria fue de 6,53 (rango 1 a 7). Se determinó que los factores asociados fueron la información entregada al paciente (p = 0,003), el acceso telefónico con familiares (p = 0,016), el uso del tiempo libre en la unidad (p < 0,001), la atención del personal de enfermería (p = 0,001), técnicos paramédicos (p = 0,003) y del personal médico (p = 0,01). Dentro de la infraestructura, solo la valoración de espacios comunes de la unidad fue significativa (p = 0,049). Conclusión principal: El nivel de satisfacción fue alto y sus factores se relacionan principalmente con la gestión del cuidado de enfermería.(AU)

Main objective: To determine the levels of user satisfaction and its associated factors in a psychiatric hospital unit in Chile. Methodology: 479 people participated, with an average age of 37,5 years (44.9% women). Descriptive statistics and a multiple linear regression model were used. Main results: The average user satisfaction was 6,53 (range 1 to 7). The associated factors were the information given to the patient (p = 0.003), telephone access to family members (p = 0.016), use of free time in the unit (p < 0.001), attention from nursing staff (p = 0.001), paramedical technicians (p = 0.003) and medical staff (p = 0.01). Within the infrastructure, only the evaluation of common areas of the unit was significant (p = 0.049). Main conclusion: The level of satisfaction was high and its factors were mainly related to nursing care management.(AU)

Victims of Cyberbullying: Feeling Loneliness and Depression among Youth and Adult Chileans during the Pandemic.

In Chile, during the COVID-19 pandemic, reports of cyberbullying victimization increased for adolescents and younger adults. Research has shown that cyber-victims-adolescents and young adults alike-are at greater risk for mental health problems such as depression as a result of this negative type of aggression. Yet, a paucity of research has examined the individual mechanisms germane to cyber-victim depression. We focused on loneliness for the current study. We hypothesized that cyber-victimization would be positively related to depressive symptoms through increased fears of loneliness and that this effect would differ between adolescents and younger adults. Thus, we examined a sample of 2370 participants from all main regions of Chile aged from 15 to 29 years. Moderated mediation results showed a negative effect of cyberbullying on depression, which was mediated by increased fears of being alone. The effect of frequency of cyberbullying on fear of loneliness was stronger for younger adults compared to adolescents. Our results suggest different mechanisms for both age groups, which can inform prevention programs and their specific activities.

Innovative Technology-Based Interventions to Reduce Stigma Toward People With Mental Illness: Systematic Review and Meta-analysis.

BACKGROUND: Stigma toward people with mental illness presents serious consequences for the impacted individuals, such as social exclusion and increased difficulties in the recovery process. Recently, several interventions have been developed to mitigate public stigma, based on the use of innovative technologies, such as virtual reality and video games. OBJECTIVE: This review aims to systematically review, synthesize, measure, and critically discuss experimental studies that measure the effect of technological interventions on stigmatization levels. METHODS: This systematic review and meta-analysis was based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines and included studies in English and Spanish published between 2016 and 2021. Searches were run in 5 different databases (ie, PubMed, PsycInfo, Scopus, Cochrane Library, and ScienceDirect). Only randomized controlled trials were included. Two independent reviewers determined the eligibility, extracted data, and rated methodological quality of the studies. Meta-analyses were performed using the Comprehensive Meta-Analysis software. RESULTS: Based on the 1158 articles screened, 72 articles were evaluated as full text, of which 9 were included in the qualitative and quantitative syntheses. A diversity of interventions was observed, including video games, audiovisual simulation of hallucinations, virtual reality, and electronic contact with mental health services users. The meta-analysis (n=1832 participants) demonstrated that these interventions had a consistent medium effect on reducing the level of public stigma (d=-0.64; 95% CI 0.31-0.96; P<.001). CONCLUSIONS: Innovative interventions involving the use of technologies are an effective tool in stigma reduction, therefore new challenges are proposed and discussed for the demonstration of their adaptability to different contexts and countries, thus leading to their massification. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42021261935; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021261935.

The role of family support and conflict in cyberbullying and subjective well-being among Chilean adolescents during the Covid-19 period.

Introduction: Life satisfaction plays a crucial role in integral development and mental health during childhood and adolescence. Recently, it has been shown that cyberbullying has severe consequences for the mental health and wellbeing of victims such as increased anxiety, depressive symptoms and even suicide risk. Although the role of the family in life satisfaction and cyberbullying behaviors has been studied, there is limited information on its impacts during the current pandemic period. Objective: The aim of this study is to determine the role of family variables regarding students' levels of life satisfaction and cyberbullying victimization during the pandemic period. Method: Structural equation modeling was done using data from a cross-sectional study (n = 287; age ranged 14-18) conducted in six schools in Santiago, Chile during 2020. Results: The tested model has a good fit and parsimonious adjustment. It explained 25.9% of the life satisfaction and 9% of the variance of cyberbullying victimization. Family support was positively associated with life satisfaction (p < 0.001) and negatively associated with cyberbullying victimization (p < 0.05). Likewise, family conflict was positively associated with levels of cyberbullying victimization (p < 0.05) and negatively associated with life satisfaction levels (p < 0.001). Finally, family visits were only positively associated with life satisfaction (p < 0.01). Conclusions: Generating interventions on several levels focused on positive family bonds has become essential and urgent. This is especially important considering their protective impacts on cyberbullying victimization in promotion of adolescent well-being and quality of life.

Controlled Study of the Impact of a Virtual Program to Reduce Stigma Among University Students Toward People With Mental Disorders.

Stigma toward mental disorders is one of today's most pressing global issues. The Covid-19 pandemic has exacerbated the barriers to social inclusion faced by individuals with mental disorders. Concurrently, stigma reduction interventions, especially those aimed at university students, have been more difficult to implement given social distancing and campus closures. As a result, alternative delivery for programs contributing to stigma reduction is required, such as online implementation. This paper reports the results of a controlled study focused on an online multi-component program on reducing stigma toward mental illness that included project-based learning, clinical simulations with standardized patients and E-Contact with real patients. A total of 40 undergraduate students from the Universidad del Desarrollo in Santiago, Chile, participated in the study. They were randomly divided between an intervention and control group. The intervention group participated in the online multi-component program, while the control group participated in an online educational program on cardiovascular health. We assessed the impact of the program by using the validated Spanish-language versions of the Attribution Questionnaire AQ-27 and the Questionnaire on Student Attitudes toward Schizophrenia with both groups, before and after the intervention. In addition, an ad hoc Likert scale ranging from 0 to 5 was used with the intervention group in order to assess the learning strategies implemented. Following the intervention, the participants belonging to the intervention group displayed significantly lower levels of stereotypes, perception of dangerousness, and global score toward people with schizophrenia (p < 0.001). In addition, participants presented lower levels of dangerousness-fear, avoidance, coercion, lack of solidarity, and global score (p < 0.001). The control group displayed no statistically significant differences in the level of stigma before and after the evaluation, for all of the items assessed. Finally, the overall assessment of each of the components of the program was highly positive. In conclusion, the study shows that online programs can contribute to reducing stigma toward mental disorders. The program assessed in this study had a positive impact on all the dimensions of stigma and all of the components of the program itself were positively evaluated by the participants.