Impact of the COVID-19-pandemic and perception of self-efficacy on the mental health of out-of-hospital emergency healthcare professionals by modality of care.

OBJECTIVE: To analyse the influence of the COVID-19 pandemic and the perception of self-efficacy on the health professionals of the Spanish out-of-hospital emergency services. DESIGN: Observational, cross-sectional and descriptive with a survey methodology of 1710 participants from Spain (1 February-30 April, 2021). METHODS: The mental health of healthcare workers was assesed in terms of stress, anxiety and depression, as well as their self-efficacy. Linear and logistic regression models were fitted to predict these variables. A moderation analysis was conducted to determine the effect of self-efficacy on mental health. RESULTS: The means of the sample for stress, anxiety, depression and self-efficacy were 20.60, 15.74, 13.07 and 70.87, respectively. In the regression models, being a woman was the most significant factor for severe mental health impairment. Female gender was also a relevant factor for self-efficacy. Self-efficacy had a direct effect on the mental health for working in patient care. CONCLUSIONS: Healthcare workers showed moderate stress, severe anxiety, mild depression and good self-efficacy. Direct patient care was associated with more stress and severe anxiety. Age, female gender, job changes and job adjustment were associated with levels of stress, anxiety and depression. Self-efficacy is a determining factor of mental health in the direct care modality. IMPLICATIONS: The mental health of healthcare workers has been of great importance in the aftermath of the pandemic, but out-of-hospital emergency workers have been neglected in research. The levels of stress, anxiety and depression during the pandemic justify the creation of prevention and early diagnosis programmes, as they are essential in a health disaster. Surprisingly, their high level of perceived self-efficacy directly impact on the mental health of patient helthcare workers, so improving it will reduce the psychological risk. REPORTING METHOD: We have followed the STROBE guidelines. It has been partially funded by the Asistencia Sanitanitaria Interprovincial de Seguros - ASISA Foundation (Spain). PATIENT OR PUBLIC CONTRIBUTION: 'No patient or public involvement'.

[Observational study of the adherence to the correct use of face masks by the general population in open public places during two periods of the COVID-19 pandemic in four Spanish cities.] / Estudio observacional de la adherencia al correcto uso de mascarillas por la población general en lugares públicos abiertos durante dos periodos de la pandemia por COVID-19 en 4 ciudades españolas.

OBJECTIVE: One of the steps adopted to mitigate the pandemic due to SARS-CoV-2 is the use of face masks by the general population. For a face mask to be effective it should cover the nose and the mouth. We wanted to measure the correct use of the face mask by the general population in open public spaces through direct observation. METHODS: We conducted an observational study of the proper use of face masks among the general population in open public places in Bilbao, Santander, Oviedo and Zaragoza from 16th to 26th July, 2020 and from 23rd January to 2nd March, 2021. Sampling for convenience; compliance of the proper use of a mask was evaluated when adults completely covered their mouth and nose. The type of mask and its improper use was registered using a standardized form. The results were obtained using frequency distribution, Pearson's chi-squared test and multivariate logistic regression analysis. RESULTS: A total of 5,464 observations were documented. The overall compliance was 89.5%. We observed that the compliance in 2021 (94.7%) was 10.9 percentage points higher than in 2020 (83.8%) (p<0.001). The main cause of non-compliance was the incorrect placement of face masks (64%); 36% were without masks. The non-reusable face masks were most commonly worn (54.1%). We observed a significant increase in use of high-efficiency face masks in 2021 (27.1%) versus 2020 (13.7%). CONCLUSIONS: In all the cities where the study was conducted we observed an increase in compliance of the proper use of face masks as well as an increased usage of high-efficiency masks. The main cause of non-compliance was incorrect placement.

OBJETIVO: Dentro de las medidas adoptadas para mitigar la pandemia por SARS-CoV-2 se encuentra el uso de mascarillas en la población general. Para que esta medida sea efectiva las mascarillas deben cubrir la nariz y la boca. Nos propusimos conocer su uso correcto por la población general en espacios públicos abiertos mediante observación directa. METODOS: Estudio prospectivo observacional del correcto uso de mascarillas en la población general en espacios abiertos en Bilbao, Santander, Oviedo y Zaragoza, del 16 al 26/07/2020 y del 23/01 al 02/03/2021. Se realizó un muestreo por conveniencia evaluando el cumplimiento del uso de mascarilla cuando los adultos la llevaban cubriendo completamente nariz y boca. Se registró el tipo e inadecuación de su uso mediante formulario estandarizado. Se realizó distribución de frecuencias, comparaciones con χ2 de Pearson y regresión logística multivariable. RESULTADOS: Se realizaron 5.464 observaciones. El cumplimiento global fue del 89,5%; 10,9 puntos mayor en 2021 (94,7%) que en 2020 (83,8%) (p<0,001). La principal causa de incumplimiento fue la colocación incorrecta (64%) frente no llevar nada (36%). Respecto al tipo de mascarillas, las más utilizadas fueron las no reutilizables (54,1%), aumentando en 2021 el uso de las de alta eficacia (13,7% versus 27,6%) de forma significativa. CONCLUSIONES: En todas las ciudades estudiadas se observa un aumento del uso correcto de la mascarilla desde que se hizo obligatorio en espacios públicos, así como aumento de las mascarillas de alta eficacia. La principal causa de incumplimiento es llevar la mascarilla mal colocada.

[Nontraumatic medical emergencies in mountain rescues]. / Utilidad de la ecografi ́a en urgencias: el protocolo RUSH.

OBJECTIVES: To describe the clinical and epidemiologic characteristics of patients with nontraumatic medical problems rescued by a Spanish mountain emergency response service (061 Aragon). MATERIAL AND METHODS: Retrospective observational analysis of records of mountain rescues completed between July 2010 and December 2016. RESULTS: A total of 164 patients with nontraumatic medical emergencies were rescued; 82.3% were males. Most patients were between the ages of 50 and 59 years. Environmentally related problems, most often hypothermia, accounted for 36.6% of the emergencies. Cardiac problems led to 20.7% and digestive problems to 12.8%. Eighty-two percent of the patients were hiking or engaged in general mountain activities (other than rock climbing, canyoning, hunting, or skiing). CONCLUSION: Recent years have seen a rise in the number of patients requiring rescue from mountains for nontraumatic medical emergencies, particularly heart problems. The typical patient to expect would be a man between the ages of 50 and 59 years who is hiking in the summer.

OBJETIVO: Describir las características clínico-epidemiológicas de los pacientes rescatados por la unidad de rescate de montaña del 061 de Aragón que presentaron patologías médicas no traumáticas. METODO: Estudio observacional retrospectivo de los rescates de montaña realizados entre julio de 2010 y diciembre de 2016. RESULTADOS: Se analizaron 164 pacientes con patología médica de origen no traumático durante el rescate (82,3% varones). El intervalo de edad más frecuente fue de 50 a 59 años. El 36,6% presentaban patologías relacionadas con el medio, siendo la hipotermia la más frecuente. El 20,7% fue patología cardiaca y el 12,8% fueron problemas digestivos. La actividad practicada por los pacientes fue el senderismo/montañismo en un 82% de las ocasiones. CONCLUSIONES: Se observa un aumento del número de pacientes rescatados con patología médica no traumática en los últimos años, y destaca el aumento de problemas cardiacos. El paciente tipo esperable sería un varón de entre 50 y 59 años practicando senderismo en época estival.

Estudio observacional de la adherencia al correcto uso de mascarillas por la población general en lugares públicos abiertos durante dos periodos de la pandemia por COVID-19 en 4 ciudades españolas / Evaluation of the effectiveness of a school-based alcohol and cannabis prevention programme among adolescents

Fundamentos: Dentro de las medidas adoptadas para mitigar la pandemia por SARS-CoV-2 se encuentra el uso de mascarillas en la población general. Para que esta medida sea efectiva las mascarillas deben cubrir la nariz y la boca. Nos propusimos conocer su uso correcto por la población general en espacios públicos abiertos mediante observación directa. Métodos: Estudio prospectivo observacional del correcto uso de mascarillas en la población general en espacios abiertos en Bilbao, Santander, Oviedo y Zaragoza, del 16 al 26/07/2020 y del 23/01 al 02/03/2021. Se realizó un muestreo por conveniencia evaluando el cumplimiento del uso de mascarilla cuando los adultos la llevaban cubriendo completamente nariz y boca. Se registró el tipo e inadecuación de su uso mediante formulario estandarizado. Se realizó distribución de frecuencias, comparacionescon χ2 de Pearson y regresión logística multivariable. Resultados: Se realizaron 5.464 observaciones. El cumplimiento global fue del 89,5%; 10,9 puntos mayor en 2021 (94,7%) que en 2020 (83,8%) (p<0,001). La principal causa de incumplimiento fue la colocación incorrecta (64%) frente no llevar nada (36%). Respecto al tipo de mascarillas, las más utilizadas fueron las no reutilizables (54,1%), aumentando en 2021 el uso de las de alta eficacia (13,7% versus 27,6%) de forma significativa. Conclusiones: En todas las ciudades estudiadas se observa un aumento del uso correcto de la mascarilla desde que se hizo obligatorio en espacios públicos, así como aumento de las mascarillas de alta eficacia. La principal causa de incumplimiento es llevar la mascarilla mal colocada.(AU)

Background: One of the steps adopted to mitigate the pandemic due to SARS-CoV-2 is the use of face masks by the general population. For a face mask to be effective it should cover the nose and the mouth. We wanted to measure the correct use of the face mask by the general population in open public spaces through direct observation. Methods: We conducted an observational study of the proper use of face masks among the general population in open public places in Bilbao, Santander, Oviedo and Zaragoza from 16th to 26th July, 2020 and from 23rd January to 2nd March, 2021. Sampling for convenience; compliance of the proper use of a mask was evaluated when adults completely covered their mouth and nose. The type of mask and its improper use was registered using a standardized form. The results were obtained using frequency distribution, Pearson’s chisquared testand multivariate logistic regression analysis. Results: A total of 5,464 observations were documented. The overall compliance was 89.5%. We observed that the compliance in 2021 (94.7%) was 10.9 percentage points higher than in 2020 (83.8%) (p<0.001). The main cause of noncompliance was the incorrect placement of face masks (64%); 36% were without masks. The nonreusable face masks were most commonly worn (54.1%). We observed a significant increase in use of highefficiency face masks in 2021 (27.1%) versus 2020 (13.7%). Conclusions: In all the cities where the study was conducted we observed an increase in compliance of the proper use of face masks as well as an increased usage ofhighefficiency masks. The main cause of non-compliance was incorrect placement.(AU)

Patología médica no traumática en pacientes rescatados en montaña / Nontraumatic medical emergencies in mountain rescues

Objetivo. Describir las características clínico-epidemiológicas de los pacientes rescatados por la unidad de rescate de montaña del 061 de Aragón que presentaron patologías médicas no traumáticas. Método. Estudio observacional retrospectivo de los rescates de montaña realizados entre julio de 2010 y diciembre de 2016. Resultados. Se analizaron 164 pacientes con patología médica de origen no traumático durante el rescate (82,3% varones). El intervalo de edad más frecuente fue de 50 a 59 años. El 36,6% presentaban patologías relacionadas con el medio, siendo la hipotermia la más frecuente. El 20,7% fue patología cardiaca y el 12,8% fueron problemas digestivos. La actividad practicada por los pacientes fue el senderismo/montañismo en un 82% de las ocasiones. Conclusiones. Se observa un aumento del número de pacientes rescatados con patología médica no traumática en los últimos años, y destaca el aumento de problemas cardiacos. El paciente tipo esperable sería un varón de entre 50 y 59 años practicando senderismo en época estival (AU)

Objective. To describe the clinical and epidemiologic characteristics of patients with nontraumatic medical problems rescued by a Spanish mountain emergency response service (061 Aragon). Methods. Retrospective observational analysis of records of mountain rescues completed between July 2010 and December 2016. Results. A total of 164 patients with nontraumatic medical emergencies were rescued; 82.3% were males. Most patients were between the ages of 50 and 59 years. Environmentally related problems, most often hypothermia, accounted for 36.6% of the emergencies. Cardiac problems led to 20.7% and digestive problems to 12.8%. Eighty-two percent of the patients were hiking or engaged in general mountain activities (other than rock climbing, canyoning, hunting, or skiing). Conclusion. Recent years have seen a rise in the number of patients requiring rescue from mountains for nontraumatic medical emergencies, particularly heart problems. The typical patient to expect would be a man between the ages of 50 and 59 years who is hiking in the summer (AU)