Order out of chaos: Sense of coherence and the mediating role of coping resources in explaining mental health during COVID-19 in 7 countries.

In the midst of the COVID-19 pandemic and the universal chaos created by it, this study explores the role of sense of coherence (Soc, Antonovsky, 1979) and how it enables coping with a stressful situation and staying well. SOC is a generalized orientation which allows one to perceive the world as comprehensible, manageable, and meaningful. In an attempt to understand 'how does the SOC work' we employed the salutogenic assumption that a strong SOC allows one to reach out in any given situation and find those resources appropriate to the specific stressor. Thus, we hypothesized that the positive impact of SOC on mental health outcomes would be mediated through coping resources that are particularly salient in times of crisis. One resource is related to the micro level (perceived family support) and the other concerns the macro level (trust in leaders and social-political institutions). Data collection was conducted in different countries during May-June 2020 via online platforms. The data included 7 samples of adult participants (age 18-90) from Israel (n â€‹= â€‹669), Italy (n â€‹= â€‹899), Spain (n â€‹= â€‹476), Germany (n â€‹= â€‹708), Austria (n â€‹= â€‹1026), Switzerland (n â€‹= â€‹147), and the U.S. (n â€‹= â€‹506). The questionnaires included standard tools (MHC-SF, SOC-13) as well as questionnaires of perceived family support and trust that were adapted to the pandemic context. As expected, SOC was associated with mental health in all the samples. Perceived family support and trust in leaders and social-political institutions mediated the relationships between SOC and mental health, controlling for age, gender, and level of financial risk. It appears that SOC has a universal meaning, not limited by cultural and situational characteristics. The discussion focuses on the theoretical, social, and political applications of the salutogenic model - and its core concept of SOC - in the context of coping with a global pandemic across different cultural contexts and countries.

Future directions for the concept of salutogenesis: a position article.

Aaron Antonovsky advanced the concept of salutogenesis almost four decades ago (Antonovsky, Health, Stress and Coping. Jossey-Bass, San Francisco, CA, 1979; Unravelling the Mystery of Health. Jossey-Bass, San Francisco, CA, 1987). Salutogenesis posits that life experiences shape the sense of coherence (SOC) that helps to mobilize resources to cope with stressors and manage tension successfully (determining one's movement on the health Ease/Dis-ease continuum). Antonovsky considered the three-dimensional SOC (i.e. comprehensibility, manageability, meaningfulness) as the key answer to his question about the origin of health. The field of health promotion has adopted the concept of salutogenesis as reflected in the international Handbook of Salutogenesis (Mittelmark et al., The Handbook of Salutogenesis. Springer, New York, 2016). However, health promotion mostly builds on the more vague, general salutogenic orientation that implies the need to foster resources and capacities to promote health and wellbeing. To strengthen the knowledge base of salutogenesis, the Global Working Group on Salutogenesis (GWG-Sal) of the International Union of Health Promotion and Education produced the Handbook of Salutogenesis. During the creation of the handbook and the regular meetings of the GWG-Sal, the working group identified four key conceptual issues to be advanced: (i) the overall salutogenic model of health; (ii) the SOC concept; (iii) the design of salutogenic interventions and change processes in complex systems; (iv) the application of salutogenesis beyond health sector. For each of these areas, we first highlight Antonovsky's original contribution and then present suggestions for future development. These ideas will help guide GWG-Sal's work to strengthen salutogenesis as a theory base for health promotion.

Salutogenic health promotion program for migrant women at risk of social exclusion.

BACKGROUND: Migrant women at risk of social exclusion often experience health inequities based on gender, country of origin or socioeconomic status. Traditional health promotion programs designed for this population have focused on covering their basic needs or modifying lifestyle behaviors. The salutogenic model of health could offer a new perspective enabling health promotion programs to reduce the impact of health inequities. This study evaluated the effectiveness of a salutogenic health promotion program focused on the empowerment of migrant women at risk of social exclusion. METHODS: A four-session salutogenic health promotion program was conducted over a period of 6 months. In a quasi-experimental pre-test post-test design, an ad hoc questionnaire was administered to 26 women to collect sociodemographic data, together with 5 validated instruments: Antonovsky's Sense of Coherence (SOC-13), Duke-UNC-11 (perceived social support), Quality of Life Short Form-36 (SF-36), Rosenberg's Self-Esteem Scale, and the Cohen et al. Perceived Stress Scale (PSS-10). Descriptive analysis and multiple linear regression models were performed. Statistical tests were considered significant with a two-tailed p value < 0.05. RESULTS: Participants had a low initial SOC-13 score (60.36; SD 8.16), which did not show significant change after the health promotion program. Perceived social support (37.07; SD 6.28) and mental quality of life also remained unchanged, while physical quality of life increased from 50.84 (SD 4.60) to 53.08 (SD 5.31) (p = 0.049). Self-esteem showed an increasing trend from 30.14 (SD 4.21) to 31.92 (SD 4.38) (p = 0.120). Perceived stress decreased from 20.57 (SD 2.91) to 18.38 (SD 3.78) (p = 0.016). A greater effect was observed at the end of the program in women with lower initial scores for SOC-13 and quality of life and higher initial scores of perceived stress. CONCLUSIONS: The health promotion program reduced perceived stress, increased physical quality of life and showed a trend toward increased self-esteem, especially among migrant women with multiple vulnerability factors. The salutogenic model of health should be considered as a good practice to apply in health promotion programs and to be included in national policies to reduce health inequity in migrant populations.

Are nurses sufficiently well prepared to take on the detection of hypertension? / ¿Está el personal de enfermería lo suficientemente preparado para detectar la hipertensión?

The detection of arterial hypertension requires training and knowledge by the responsible health professional. The current guidelines recommend doctors and nurses to work together for the screening of hypertension. Objectives: To assess the level of knowledge among primary healthcare nurses’ in the screening of arterial hypertension. Methods: Descriptive, observational and transversal study. A random representative sample of 165 nurses working with adult patients in community-based primary healthcare centres were asked to complete an evaluation test of theoretical knowledge about hypertension. Higher scores indicated a greater knowledge about the detection of hypertension. Results: 32.1% of the participants obtained a score equal to or more than 72.7 which corresponded to the 75th percentile of correct answers. Nurses with lower scores were older, permanent employees with technical training studies. A higher age and technical training studies contributed independently to a lower score. In the multiple linear regression model, age and type of studies contributed independently to questionnaire's score variance. Conclusion: Currently, primary care nurses in the studied region do not have sufficient theoretical knowledge to detect hypertension. The results show the need to establish strategies to achieve the necessary knowledge for the implementation of a correct hypertension screening. For professional nurses, continuing education is essential to safe and effective nursing care

Antecedentes: La detección de la hipertensión arterial requiere formación y conocimientos por parte del profesional sanitario responsable. Las directrices actuales aconsejan a los doctores y enfermeros que trabajen juntos para diagnosticar la hipertensión. Objetivos: Evaluar el nivel de conocimiento entre el personal de enfermería de atención primaria para detectar la hipertensión arterial. Métodos: Estudio descriptivo, observacional y transversal. Se pidió a una muestra aleatoria de 165 enfermeros que trabajaban con adultos en centros de atención primaria que completaran una prueba de evaluación de sus conocimientos teóricos acerca de la hipertensión. Un resultado más alto indicaba un mayor conocimiento a la hora de detectar la hipertensión. Resultados: El 32,1% de los participantes obtuvo una puntuación igual o superior a 72,7, que se correspondía con el percentil 75 de respuestas correctas. El personal de enfermería con puntuación más baja fue el de los empleados más mayores, fijos y con estudios técnicos. La edad más avanzada y tener estudios de formación técnica contribuyeron de manera independiente a una menor puntuación. En el modelo de regresión lineal múltiple la edad y el tipo de formación contribuyeron de manera independiente a la variación del resultado. Conclusión: En la actualidad el personal de enfermería de atención primaria de la región estudiada no cuenta con suficientes conocimientos para detectar la hipertensión. Los resultados muestran la necesidad de establecer estrategias para alcanzar los conocimientos necesarios y poner en marcha un adecuado plan de diagnóstico de hipertensión. Para los enfermeros profesionales una formación continuada es clave para un cuidado seguro y eficaz

Are nurses sufficiently well prepared to take on the detection of hypertension?

BACKGROUND: The detection of arterial hypertension requires training and knowledge by the responsible health professional. The current guidelines recommend doctors and nurses to work together for the screening of hypertension. OBJECTIVES: To assess the level of knowledge among primary healthcare nurses' in the screening of arterial hypertension. METHODS: Descriptive, observational and transversal study. A random representative sample of 165 nurses working with adult patients in community-based primary healthcare centres were asked to complete an evaluation test of theoretical knowledge about hypertension. Higher scores indicated a greater knowledge about the detection of hypertension. RESULTS: 32.1% of the participants obtained a score equal to or more than 72.7 which corresponded to the 75th percentile of correct answers. Nurses with lower scores were older, permanent employees with technical training studies. A higher age and technical training studies contributed independently to a lower score. In the multiple linear regression model, age and type of studies contributed independently to questionnaire's score variance. CONCLUSION: Currently, primary care nurses in the studied region do not have sufficient theoretical knowledge to detect hypertension. The results show the need to establish strategies to achieve the necessary knowledge for the implementation of a correct hypertension screening. For professional nurses, continuing education is essential to safe and effective nursing care.

Las barreras percibidas en mujeres con incontinencia urinaria / No disponible

El objetivo de esta investigación es identificar las barreras que perciben mujeres con incontinencia urinaria (IU) para emprender una conducta encaminada a la resolución de su problema con la orina. Se trata de un estudio cualitativo con la participación de 34 mujeres de la provincia de Barcelona (España). Los datos se recogieron mediante entrevistas en profundidad y la técnica del grupo focal. La selección de la muestra fue intencional o de conveniencia y el análisis categorial temático se realizó a partir de las transcripciones de los discursos de las participantes. Los resultados muestran que entre las barreras percibidas respecto a la búsqueda de ayuda para su IU, están la falta de conciencia de la IU como enfermedad, unos conocimientos deficientes respecto a la misma y la propia actitud y práctica de algunos médicos. La falta de tiempo y el cansancio las impide autocuidarse. La pereza, la falta de voluntad o de constancia en la realización de los ejercicios del suelo pélvico obstaculizan su ejecución, así como el coste económico de los centros de rehabilitación privados. Se concluye que se debe empoderar a la mujer, apoyarla y ayudarla en la realización de las conductas promotoras de salud para su IU

The objective of this research is to identify the barriers they perceive women with urinary incontinence (UI) for preventing them from undertaking conduct aimed at solving your problem with urine. This is a qualitative study involving 34 women in the province of Barcelona (Spain). Data were collected through in-depth interviews and focus group technique. The sample selection was intentional or convenience categorical and thematic analysis was conducted from the transcripts of the speeches of the participants. The results show that perceived barriers regarding seeking help for UI, is the lack of awareness of the UI as a disease, a deficient knowledge about it and the right attitude and practice of some doctors. The lack of time and fatigue prevents them self-care. Laziness, lack of will or perseverance in performing pelvic floor exercises, impeding its implementation as well as the economic cost of private rehabilitation centers. It is concluded that should empower women, support and assist in the conduct of health promoting behaviors for IU

[Influence of waiting time on patient and companion satisfaction]. / Influencia del tiempo de espera en la satisfacción de pacientes y acompañantes.

OBJECTIVE: To evaluate patient and companion satisfaction of a hospital Emergency Department and its relationship with waiting time. METHODOLOGY: Prospective, observational study. SETTING: Hospital de Figueres Emergency Department (Girona, Spain). STUDY VARIABLES: sociodemographic characteristics, satisfaction level, real and perceived waiting time for triage and being seen by a physician. RESULTS: A total of 285 responses were received from patients and companions. The mean age of the patients and companions (n=257) was 54.6years (SD=18.3). The mean overall satisfaction (n=273) was 7.6 (SD=2.2). Lower perceived waiting time until nurse triage was related to higher overall satisfaction (Spearman rho (ρ)=-0.242, P<.001), and lower perceived waiting time until being seen by physician, with a higher overall satisfaction (ρ=-0.304; P<.001). Users who were informed about estimated waiting time showed higher satisfaction than those who were not informed (P=.001). CONCLUSIONS: Perceived waiting time and the information about estimated waiting time determined overall satisfaction.

Influencia del tiempo de espera en la satisfacción de pacientes y acompañantes / Influence of waiting time on patient and companion satisfaction

Objetivo: Evaluar la satisfacción de pacientes y acompañantes de un servicio de urgencias hospitalario y su relación con el tiempo de espera. Método: Estudio observacional transversal. Ámbito de estudio: Servicio de Urgencias del Hospital de Figueres (Girona). Variables estudiadas: características sociodemográficas, nivel de satisfacción, tiempo de espera real y percibido hasta el triaje y la visita médica. Resultados: Se recibieron 285 respuestas. La edad media (n = 257) fue de 54,6 años (DE = 18,3). La puntuación media de la satisfacción global con la visita (n = 273) fue de 7,6 (DE = 2,2) y la mediana, de 8 (rango intercuartílico [RIC] = 2). Se observó, a menor tiempo de espera percibido hasta ser atendidos por la enfermera de triaje, mayor satisfacción global (ρ = −0,242, p < 0,001), y a menor tiempo de espera percibido hasta la visita médica, mayor satisfacción global (ρ = −0,304; p < 0,001). Los usuarios que fueron informados sobre el tiempo de espera hasta la visita médica mostraron mayor satisfacción que los que no fueron informados (p = 0,001). Conclusiones: La satisfacción de los usuarios del servicio de urgencias es elevada. La percepción del tiempo de espera y la información sobre este tiempo influyó en la satisfacción de los usuarios (AU)

Objective: To evaluate patient and companion satisfaction of a hospital Emergency Department and its relationship with waiting time. Methodology: Prospective, observational study. Setting: Hospital de Figueres Emergency Department (Girona, Spain). Study variables: sociodemographic characteristics, satisfaction level, real and perceived waiting time for triage and being seen by a physician. Results: A total of 285 responses were received from patients and companions. The mean age of the patients and companions (n = 257) was 54.6 years (SD = 18.3). The mean overall satisfaction (n = 273) was 7.6 (SD = 2.2). Lower perceived waiting time until nurse triage was related to higher overall satisfaction (Spearman rho (ρ) = −0.242, P < .001), and lower perceived waiting time until being seen by physician, with a higher overall satisfaction (ρ = −0.304; P < .001). Users who were informed about estimated waiting time showed higher satisfaction than those who were not informed (P = .001). Conclusions: Perceived waiting time and the information about estimated waiting time determined overall satisfaction (AU)

[Nursing students voice their opinions regarding their profession]. / Los estudiantes de enfermería opinan sobre su profesión.

The authors research the opinions of first year nursing students about why the nursing profession does not receive the same degree of consideration which similar academic professionals receive. At the same time, the authors studied to see if this lower professional consideration is due to the predominant presence of females in the nursing profession. To collect data, the authors ran a transversal, descriptive, qualitative study by means of nominal group and discussion group techniques. Among the main results, the authors highlight that Nursing is considered a socially unknown profession and receives little acknowledgment inside the new health care model; furthermore, the fact that the majority of nurses are female does bear an influence on the vision of the nursing field and this female predominance harms competitiveness in the profession since nurses must conciliate their family lives with their professional lives.

Los estudiantes de enfermería opinan sobre su profesión / Nursing students voice their opinions regarding their profession

Se indaga la opinión de los estudiantes de primer curso de Enfermería sobre por qué el colectivo no está considerado al mismo nivel que otras profesiones académicamente similares. Así mismo, se ha estudiado si tiene que ver con la presencia mayoritaria de la mujer dentro de la profesión. Para recoger información se ha llevado a cabo un estudio transversal, descriptivo y cualitativo mediante las técnicas de grupo nominal y de discusión. Entre los principales resultados destacar que se considera la Enfermería una profesión socialmente desconocida y poco reconocida en su nuevo modelo asistencial; también, que la mayoría de los profesionales sean mujeres influye en la visión del entorno y dificulta la competitividad del colectivo al tener que conciliar la vida familiar con la laboral(AU)

The authors research the opinions of first year nursing students about why the nursing profession does not receive the same degree of consideration which similar academic professionals receive. At the same time, the authors studied to see if this lower professional consideration is due to the predominant presence of females in the nursing profession. To collect data, the authors ran a transversal, descriptive, qualitative study by means of nominal group and discussion group techniques. Among the main results, the authors highlight that Nursing is considered a socially unknown profession and receives little acknowledgment inside the new health care model; furthermore, the fact that the majority of nurses are female does bear an influence on the vision of the nursing field and this female predominance harms competitiveness in the profession since nurses must conciliate their family lives with their professional lives(AU)