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García-Vázquez B, Martínez-Alés G, Fernández-Jiménez E, Andreo-Jover J, Moreno-Küstner B, Minué S, Jaramillo F, Morán-Sánchez I, Martínez-Morata I, Ayuso-Mateos JL, Bayón C, Bravo-Ortiz MF, Mediavilla R. Use of psychological interventions among healthcare workers over the 2-year period following the COVID-19 pandemic: A longitudinal study. PLoS One 2023; 18:e0292932. [PMID: 37903088 PMCID: PMC10615285 DOI: 10.1371/journal.pone.0292932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/01/2023] [Indexed: 11/01/2023] Open
Abstract
INTRODUCTION Although healthcare workers (HCWs) have reported mental health problems since the beginning of the COVID-19 pandemic, they rarely use psychological support. Here, we described the use of psychological support among HCWs in Spain over the 2-year period following the initial pandemic outbreak and explore its association with workplace- and COVID-19-related factors measured at baseline, in 2020. MATERIALS AND METHODS We conducted a longitudinal study on HCWs working in Spain. We used an online survey to collect information on sociodemographic characteristics, depressive symptoms, workplace- and COVID-19-related variables, and the use of psychological support at three time points (2020, 2021, and 2022). Data was available for 296, 294, and 251 respondents, respectively at time points 1, 2, and 3. RESULTS Participants had a median age of 43 years and were mostly females (n = 242, 82%). The percentage of HCWs using psychological support increased from 15% in 2020 to 23% in 2022. Roughly one in four HCWs who did not use psychological support reported symptoms compatible with major depressive disorder at follow up. Baseline predictors of psychological support were having to make decisions about patients' prioritisation (OR 5.59, 95% CI 2.47, 12.63) and probable depression (wave 2: OR 1.12, 95% CI 1.06, 1.19; wave 3: OR 1.10, 95% CI 1.04, 1.16). CONCLUSIONS Our results suggest that there is call for implementing mental health promotion and prevention strategies at the workplace, along with actions to reduce barriers for accessing psychological support.
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Affiliation(s)
- Blanca García-Vázquez
- Department of Psychiatry, Clinical Psychology, and Mental Health, Hospital Universitario La Paz, Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Gonzalo Martínez-Alés
- CAUSALab, Harvard TH Chan School of Public Health, Harvard, Boston, Massachusetts, United States of America
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Eduardo Fernández-Jiménez
- Department of Psychiatry, Clinical Psychology, and Mental Health, Hospital Universitario La Paz, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Jorge Andreo-Jover
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Berta Moreno-Küstner
- Department of Personality, Assessment and Psychological Treatment, University of Málaga-IBIMA, Málaga, Spain
| | - Sergio Minué
- Andalusian School of Public Health, Granada, Spain
| | - Fabiola Jaramillo
- Andalusian School of Public Health, Granada, Spain
- University of Chile, Santiago, Chile
| | - Inés Morán-Sánchez
- Murcia BioHealth Research Institute, University of Murcia, Murcia, Spain
| | - Irene Martínez-Morata
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, United States America
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, La Princesa University Hospital - Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
| | - Carmen Bayón
- Department of Psychiatry, Clinical Psychology, and Mental Health, Hospital Universitario La Paz, Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - María-Fe Bravo-Ortiz
- Department of Psychiatry, Clinical Psychology, and Mental Health, Hospital Universitario La Paz, Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, La Princesa University Hospital - Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
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Mediavilla R, Fernández-Jiménez E, Andreo J, Morán-Sánchez I, Muñoz-Sanjosé A, Moreno-Küstner B, Mascayano F, Ayuso-Mateos JL, Bravo-Ortiz MF, Martínez-Alés G. Association between perceived discrimination and mental health outcomes among health workers during the initial COVID-19 outbreak. Spanish Journal of Psychiatry and Mental Health 2023; 16:221-224. [PMID: 34153496 PMCID: PMC8253602 DOI: 10.1016/j.rpsm.2021.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/29/2021] [Accepted: 06/10/2021] [Indexed: 10/27/2022]
Abstract
BACKGROUND During the initial COVID-19 outbreak, health systems faced unprecedented organizational stress. Meanwhile, reports of episodes of discrimination and violence towards healthcare workers increased globally. This study explores the association between perceived discrimination and mental health outcomes in a large sample of healthcare workers in Spain. MATERIALS AND METHODS Healthcare workers from inpatient and outpatient facilities (N=2,053) filled an on-line questionnaire in May or June 2020. Mental health outcomes included depression symptoms (Patient Health Questionnaire [PHQ-9]), psychological distress (General Health Questionnaire [GHQ-12]) and death thoughts (Columbia Suicide Severity Rating Scale [C-SSRS]). We also measured perceived discrimination and/or stigmatization due to being a healthcare worker since pandemic onset. Regression models adjusted for potential confounding sources (age, sex, history of a mental health diagnosis and type of job) were fitted. RESULTS Thirty percent of the respondents reported discrimination and/or stigmatization. Perceived discrimination was associated with higher depression (B=2.4, 95 percent CI: 1.8, 2.9) and psychological distress (B=1.1, 95 percent CI: 0.7, 1.4) scores, and with a 2-fold increase in risk of reporting death thoughts (OR=2.0, 95 percent CI: 1.4, 3.1). CONCLUSIONS Perceived discrimination is a modifiable driver of mental health problems among healthcare workers. Mass media, legislators, and healthcare institutions must put in place prevention and restoration strategies to limit discrimination towards healthcare workers and reduce its mental health impact.
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Affiliation(s)
- Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
| | - Eduardo Fernández-Jiménez
- Department of Psychiatry, Clinical Psychology and Mental Health, Hospital Universitario La Paz, Madrid, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Jorge Andreo
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Inés Morán-Sánchez
- Institute for Biomedical Research of Murcia (IMIB-Arrixaca), Murcia, Spain; Cartagena Mental Health Centre, Health Service of Murcia, Murcia, Spain
| | - Ainoa Muñoz-Sanjosé
- Department of Psychiatry, Clinical Psychology and Mental Health, Hospital Universitario La Paz, Madrid, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Berta Moreno-Küstner
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, Malaga, Spain; Andalusian Group of Psychosocial Research (GAP), Andalusia, Spain; Biomedical Research Institute of Malaga (IBIMA), Malaga, Spain
| | - Franco Mascayano
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States; New York State Psychiatric Institute, New York, NY, United States
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychiatry, La Princesa University Hospital, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
| | - María-Fe Bravo-Ortiz
- Department of Psychiatry, Clinical Psychology and Mental Health, Hospital Universitario La Paz, Madrid, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Gonzalo Martínez-Alés
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States; Department of Psychiatry, Clinical Psychology and Mental Health, Hospital Universitario La Paz, Madrid, Spain
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Mengual-Pujante M, Morán-Sánchez I, Luna-Ruiz Cabello A, Pérez-Cárceles MD. Attitudes of the police towards individuals with a known psychiatric diagnosis. BMC Psychiatry 2022; 22:614. [PMID: 36123659 PMCID: PMC9484251 DOI: 10.1186/s12888-022-04234-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 08/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Police officers are increasingly required to respond to incidents involving psychiatric patients. However, few studies have assessed whether the attitude of police officers depends on prior knowledge of their specific psychiatric diagnosis. Our aim was to analyze the effects of psychiatric diagnosis on the behavior of police officers. METHODS We utilized the Attribution Questionnaire adapted to the police context to examine the attitudes of 927 officers of the Spanish National Police Force towards persons diagnosed with either schizophrenia or depressive disorder playing the role of somebody in need of assistance, a victim of a crime, a witness, or a suspect in a criminal case. Different socio-demographic variables were also collected. RESULTS Compared to attitudes to individuals with a known psychiatric diagnosis, police officers expressed increased willingness to help psychiatric patients and increased sympathy and attributing to them less responsibility for their actions. They also showed increased feelings of avoidance, reported a greater perception of danger and a greater need for isolation and involuntary treatment. This was especially so in the case of schizophrenia. Stigmatizing attitudes were less apparent when the person was a woman, a veteran officer, or someone with a history of work experience. CONCLUSIONS Police officers may hold certain stigmatizing attitudes towards persons with mental illness, particularly schizophrenia, that require special attention, as they may negatively affect police action. We found several factors associated with the persistence of these stigmatizing attitudes among police officers that may guide us when implementing training programs for promoting attitude change, especially at the beginning of an officer's professional career.
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Affiliation(s)
- M. Mengual-Pujante
- grid.10586.3a0000 0001 2287 8496Department of Legal and Forensic Medicine, Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, Murcia, Spain
| | - I. Morán-Sánchez
- Cartagena Mental Health Centre, Real St 8, E-30201, Cartagena, Murcia, Spain ,grid.411967.c0000 0001 2288 3068Department of Forensic Psychiatry, Law Faculty, Catholic University of Murcia, Murcia, Spain
| | - A. Luna-Ruiz Cabello
- grid.10586.3a0000 0001 2287 8496Department of Legal and Forensic Medicine, Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, Murcia, Spain
| | - M. D. Pérez-Cárceles
- grid.10586.3a0000 0001 2287 8496Department of Legal and Forensic Medicine, Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, Murcia, Spain
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Torres-Cantero AM, Álvarez León EE, Morán-Sánchez I, San Lázaro Campillo I, Bernal Morell E, Hernández Pereña M, Martínez-Morata I. [Health impact of COVID pandemic. SESPAS Report 2022]. Gac Sanit 2022; 36 Suppl 1:S4-S12. [PMID: 35781147 PMCID: PMC9244867 DOI: 10.1016/j.gaceta.2022.02.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 02/05/2022] [Accepted: 02/06/2022] [Indexed: 12/12/2022]
Abstract
Objetivo Presentar, a los 22 meses de que la Organización Mundial de la Salud declarara como pandemia la infección global por SARS-CoV-2 el 11 de marzo de 2020, el impacto hasta el momento de la pandemia en términos de salud física y mental. Método Se han revisado resultados procedentes de metaanálisis y revisiones sistemáticas, citándose para algún aspecto específico de interés artículos individuales. La información nacional procede de la Red Nacional de Vigilancia Epidemiológica (RENAVE). Resultados Hasta finales de octubre se habían producido más de 250 millones de infecciones y 5 millones de muertes. En España se han notificado 4,7 millones de infecciones, aunque la cifra real es superior a los 7 millones. Se ha reducido la esperanza de vida, con efectos especialmente dramáticos en grupos de población con comorbilidad y de edad avanzada. Se constata un empeoramiento de la salud mental general. Es previsible que algunos colectivos, como los/las profesionales sanitarios/as, en su mayoría mujeres, y trabajadores/as de primera línea, tengan un mayor riesgo de desarrollar patologías de salud mental en el futuro. La pandemia y las medidas de control han tenido otras consecuencias indeseables, como la disminución de la actividad asistencial, el aumento del sedentarismo y el aumento de la violencia de género. Conclusiones Son necesarios estudios longitudinales para determinar la magnitud de las consecuencias de la propia infección y de las medidas de control y las actuaciones necesarias.
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Affiliation(s)
- Alberto Manuel Torres-Cantero
- IMIB-Arrixaca, Murcia, España; Servicio de Medicina Preventiva, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España; Departamento de Ciencias Sociosanitarias, Facultad de Medicina, Universidad de Murcia, Murcia, España.
| | - Eva Elisa Álvarez León
- Servicio de Medicina Preventiva, Complejo Hospitalario Universitario Insular Materno Infantil, Servicio Canario de la Salud, Las Palmas de Gran Canaria, España; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - Inés Morán-Sánchez
- IMIB-Arrixaca, Murcia, España; CSM Cartagena, Servicio Murciano de Salud, Cartagena (Murcia), España
| | - Indra San Lázaro Campillo
- IMIB-Arrixaca, Murcia, España; Servicio de Medicina Preventiva, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - Enrique Bernal Morell
- IMIB-Arrixaca, Murcia, España; Departamento de Ciencias Sociosanitarias, Facultad de Medicina, Universidad de Murcia, Murcia, España; Hospital General Universitario Reina Sofía, Murcia, España
| | - Marcos Hernández Pereña
- IMIB-Arrixaca, Murcia, España; Servicio de Medicina Preventiva, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - Irene Martínez-Morata
- IMIB-Arrixaca, Murcia, España; Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, USA
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Mediavilla R, Fernández-Jiménez E, Martinez-Morata I, Jaramillo F, Andreo-Jover J, Morán-Sánchez I, Mascayano F, Moreno-Küstner B, Minué S, Ayuso-Mateos JL, Bryant RA, Bravo-Ortiz MF, Martínez-Alés G. Sustained Negative Mental Health Outcomes Among Healthcare Workers Over the First Year of the COVID-19 Pandemic: A Prospective Cohort Study. Int J Public Health 2022; 67:1604553. [PMID: 35814735 PMCID: PMC9266625 DOI: 10.3389/ijph.2022.1604553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 05/31/2022] [Indexed: 12/03/2022] Open
Abstract
Objective: To characterize the evolution of healthcare workers' mental health status over the 1-year period following the initial COVID-19 pandemic outbreak and to examine baseline characteristics associated with resolution or persistence of mental health problems over time. Methods: We conducted an 8-month follow-up cohort study. Eligible participants were healthcare workers working in Spain. Baseline data were collected during the initial pandemic outbreak. Survey-based self-reported measures included COVID-19-related exposures, sociodemographic characteristics, and three mental health outcomes (psychological distress, depression symptoms, and posttraumatic stress disorder symptoms). We examined three longitudinal trajectories in mental health outcomes between baseline and follow-up assessments (namely asymptomatic/stable, recovering, and persistently symptomatic/worsening). Results: We recruited 1,807 participants. Between baseline and follow-up assessments, the proportion of respondents screening positive for psychological distress and probable depression decreased, respectively, from 74% to 56% and from 28% to 21%. Two-thirds remained asymptomatic/stable in terms of depression symptoms and 56% remained symptomatic or worsened over time in terms of psychological distress. Conclusion: Poor mental health outcomes among healthcare workers persisted over time. Occupational programs and mental health strategies should be put in place.
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Affiliation(s)
- Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- University Hospital La Paz Research Institute (IdiPAZ), Madrid, Spain
| | - Eduardo Fernández-Jiménez
- University Hospital La Paz Research Institute (IdiPAZ), Madrid, Spain
- University Hospital La Paz, La Paz, Spain
| | - Irene Martinez-Morata
- Mailman School of Public Health, Columbia University, New York City, NY, United States
- Murcia BioHealth Research Institute, University of Murcia, Murcia, Spain
| | - Fabiola Jaramillo
- Andalusian School of Public Health, Granada, Spain
- University of Chile, Santiago, Chile
| | - Jorge Andreo-Jover
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- University Hospital La Paz Research Institute (IdiPAZ), Madrid, Spain
| | - Inés Morán-Sánchez
- Murcia BioHealth Research Institute, University of Murcia, Murcia, Spain
| | - Franco Mascayano
- Mailman School of Public Health, Columbia University, New York City, NY, United States
- New York State Psychiatric Institute (NYSPI), New York City, NY, United States
| | - Berta Moreno-Küstner
- Department of Personality, Assessment, and Psychological Treatment, University of Malaga, Málaga, Spain
- Instituto de Investigaciones Biomédicas de Málaga, Universidad de Málaga, Málaga, Spain
| | - Sergio Minué
- Andalusian School of Public Health, Granada, Spain
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Fundación Biomédica, Hospital de La Princesa, Madrid, Spain
| | - Richard A. Bryant
- School of Psychology, University of New South Wales, Kensington, NSW, Australia
| | - María-Fe Bravo-Ortiz
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- University Hospital La Paz Research Institute (IdiPAZ), Madrid, Spain
- University Hospital La Paz, La Paz, Spain
| | - Gonzalo Martínez-Alés
- University Hospital La Paz Research Institute (IdiPAZ), Madrid, Spain
- Mailman School of Public Health, Columbia University, New York City, NY, United States
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Mediavilla R, Fernández-Jiménez E, Martínez-Alés G, Moreno-Küstner B, Martínez-Morata I, Jaramillo F, Morán-Sánchez I, Minué S, Torres-Cantero A, Alvarado R, Ayuso-Mateos JL, Mascayano F, Susser E, Bravo-Ortiz MF. Role of access to personal protective equipment, treatment prioritization decisions, and changes in job functions on health workers' mental health outcomes during the initial outbreak of the COVID-19 pandemic. J Affect Disord 2021; 295:405-409. [PMID: 34507219 PMCID: PMC8403068 DOI: 10.1016/j.jad.2021.08.059] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 08/21/2021] [Accepted: 08/24/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND During the initial COVID-19 outbreak, organizational changes were required to ensure adequate staffing in healthcare facilities. The extent to which organizational changes impacted the mental wellbeing of healthcare workers (HCWs) remains unexplored. Here we analyzed the association between three work-related stressors (reported access to protective equipment, change in job functions, and patient prioritization decision-making) and mental health outcomes (depression symptoms, psychological distress, suicidal thoughts, and fear of infection) in a large sample of Spanish HCWs during the initial COVID-19 outbreak. METHODS We conducted a cross-sectional study including HCWs from three regions of Spain between April 24th and June 22nd, 2020. An online survey measured sociodemographic characteristics, work-related stressors, fear of infection, and mental health outcomes (depression [PHQ-9], psychological distress [GHQ-12], death wishes [C-SSRS]). We conducted mixed-effects regression models to adjust all associations for relevant individual- and region-level sources of confounding. RESULTS We recruited 2,370 HCWs. Twenty-seven percent screened positive for depression and 74% for psychological distress. Seven percent reported death wishes. Respondents were more afraid of infecting their loved ones than of getting infected themselves. All work-related stressors were associated with depression symptoms and psychological distress in adjusted models. LIMITATIONS Non-probabilistic sampling, potential reverse causation. CONCLUSIONS Modifiable work-related stressors are associated with worse mental health among HCWs. Our results suggest that workplace prevention strategies for HCWs should provide sufficient protective equipment, minimize changes in job functions, favor the implementation of criteria for patient triage and on-call bioethics committees, and facilitate access to stepped-care, evidence-based mental health treatment.
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Affiliation(s)
- Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain,Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Eduardo Fernández-Jiménez
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain,Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Gonzalo Martínez-Alés
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States; Institute of Health Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
| | - Berta Moreno-Küstner
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, Malaga, Spain,Andalusian Group of Psychosocial Research (GAP), Andalusia, Spain,Biomedical Research Institute of Malaga (IBIMA), Malaga, Spain
| | - Irene Martínez-Morata
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, United States,Institute for Biomedical Research of Murcia (IMIB-Arrixaca), Murcia, Spain
| | - Fabiola Jaramillo
- Andalusian School of Public Health, Andalusia, Spain,Program of Mental Health, Universidad de Chile, Santiago de Chile, Chile
| | - Inés Morán-Sánchez
- Institute for Biomedical Research of Murcia (IMIB-Arrixaca), Murcia, Spain,Cartagena Mental Health Centre, Health Service of Murcia, Murcia, Spain
| | - Sergio Minué
- Andalusian School of Public Health, Andalusia, Spain
| | - Alberto Torres-Cantero
- Institute for Biomedical Research of Murcia (IMIB-Arrixaca), Murcia, Spain,Department of Preventive Medicine, Virgen de la Arrixaca Hospital, Murcia, Spain
| | - Rubén Alvarado
- Program of Mental Health, Universidad de Chile, Santiago de Chile, Chile
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain,Institute of Health Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain,Department of Psychiatry, La Princesa University Hospital, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
| | - Franco Mascayano
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States,New York State Psychiatric Institute, New York, NY, United States
| | - Ezra Susser
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States,New York State Psychiatric Institute, New York, NY, United States
| | - María-Fe Bravo-Ortiz
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain,Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain,Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain,Institute of Health Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
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Morán-Sánchez I, Bernal-López MDLÁ, Salmerón D, Pérez-Cárceles MD. Correlates of preferring a passive role in decision-making among patients with schizophrenia or bipolar disorder. Patient Educ Couns 2021; 104:1125-1131. [PMID: 33268230 DOI: 10.1016/j.pec.2020.10.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 09/18/2020] [Accepted: 10/13/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To assess the factors associated with the persistence of clinician-led style in the therapeutic relationship in cases of serious mental illness, and the conditioning factors that the patients identify as determinants of their health. METHOD Assessment of preferences in the decision-making process and health-related control locus of 107 outpatients with DSM-5 diagnosis of schizophrenia or bipolar disorder. Demographic and clinical information was also obtained through review of available records and using several scales. RESULTS 64.4 % patients preferred to adopt a passive role in the therapeutic relationship. In the multivariate analysis, the preference of playing a passive role in the decision-making process was significantly associated with the elderly, being disabled, or the view that one's health depends on doctors (AUC ROC value: 0.80). CONCLUSIONS Patients with severe mental illness more frequently preferred a passive role in the decision-making process. We found several factors associated with a preference for the "expert role" model. PRACTICE IMPLICATIONS The identified factors may permit care to be tailored to the most probable expectations as regard decision-making. Since the populations concerned may be vulnerable and suffer inequalities in the provision of health services, promoting participation in the care process could help improve clinical parameters ethically.
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Affiliation(s)
- Inés Morán-Sánchez
- Health Service of Murcia, Cartagena Mental Health Centre, Cartagena, Spain.
| | | | - Diego Salmerón
- Health Sciences Department, University of Murcia, Espinardo, Spain
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Morán-Sánchez I, Adoamnei E, Sánchez-Ferrer ML, Prieto-Sánchez MT, Arense-Gonzalo JJ, Casanova-Mompeán V, Carmona-Barnosi A, Mendiola J, Torres-Cantero AM. Is dispositional optimism associated with endometriomas and deep infiltrating endometriosis? J Psychosom Obstet Gynaecol 2021; 42:50-56. [PMID: 32081052 DOI: 10.1080/0167482x.2020.1729732] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION Endometriosis is a chronic painful condition characterized by high prognostic uncertainty, as well as the threat of infertility and emotional symptoms that may affect many aspects of women, including psychological characteristics like dispositional optimism. Considering the impact of endometriosis on psychological health and the paucity of papers on this topic, the aim of this study is to explore optimism and associated factors in endometriosis. METHODS A case-control study was performed on a group of 95 women with endometriosis and 156 controls. All participants completed the Life Orientation Test-Revised (LOT-R), a self-administered tool for assessing dispositional optimism. Pain severity, medication, gynecological and socio-demographic information was also collected. RESULTS Low optimism was observed for women with endometriosis compared to controls even after covariate adjustment (LOT-R global scores: 14.5 vs. 15.9 points, p = .045). CONCLUSIONS This study provides the first evidence that a personality dimension with many prognostic implications may be altered in women with endometriosis. Our findings highlight the importance of a broader understanding of this condition, treating this disorder from a biopsychosocial perspective and suggests the need for non-medical attention within a multidisciplinary team.
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Affiliation(s)
| | - Evdochia Adoamnei
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar Murcia, Spain.,Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, Espinardo Murcia, Spain
| | - María Luisa Sánchez-Ferrer
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar Murcia, Spain.,Department of Obstetrics and Gynecology, 'Virgen de la Arrixaca' University Clinical Hospital, University of Murcia, El Palmar Murcia, Spain
| | - María Teresa Prieto-Sánchez
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar Murcia, Spain.,Department of Obstetrics and Gynecology, 'Virgen de la Arrixaca' University Clinical Hospital, University of Murcia, El Palmar Murcia, Spain
| | - Julián Jesús Arense-Gonzalo
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, Espinardo Murcia, Spain
| | - Virginia Casanova-Mompeán
- Department of Obstetrics and Gynecology, 'Virgen de la Arrixaca' University Clinical Hospital, University of Murcia, El Palmar Murcia, Spain
| | - Ana Carmona-Barnosi
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar Murcia, Spain.,Department of Obstetrics and Gynecology, 'Virgen de la Arrixaca' University Clinical Hospital, University of Murcia, El Palmar Murcia, Spain
| | - Jaime Mendiola
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar Murcia, Spain.,Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, Espinardo Murcia, Spain
| | - Alberto Manuel Torres-Cantero
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar Murcia, Spain.,Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, Espinardo Murcia, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Department of Preventive Medicine, 'Virgen de la Arrixaca' University Clinical Hospital, El Palmar Murcia, Spain
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Morán-Sánchez I, Bernal-López MA, Pérez-Cárceles MD. Compulsory admissions and preferences in decision-making in patients with psychotic and bipolar disorders. Soc Psychiatry Psychiatr Epidemiol 2020; 55:571-580. [PMID: 31728560 DOI: 10.1007/s00127-019-01809-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 11/09/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Participation in medical decisions and taking into account patients' values and preferences are especially important for psychiatric patients who may be treated against their will. The increasing rates of coercive measures and the underlying clinical, ethical, and legal issues highlight the need to examine their use in psychiatry. Although limited congruence in decision-making preferences may be on the basis of these coercive practices, this issue has not been adequately addressed. We explore the relationship between compulsory admissions and congruence in decision-making preferences in mental health settings. METHODS Cross-sectional study among 107 outpatients with DSM diagnoses of schizophrenia of bipolar disorder using the Control Preference Scale to assess congruence in decision-making experienced and preferred style. History of compulsory admissions was obtained through review of available records. Descriptive statistics and multivariate analyses were used. RESULTS 70% of patients reported experiencing their preferred style of decision-making and 44% patients had history of compulsory admissions. These patients were more autonomous and preferred to take a more active role. The degree of congruence was lower in patients with previous compulsory admissions. The best predictors of compulsory admissions were not having a regular doctor and the unmatched participation preferences. CONCLUSIONS Patients who experienced a different level of participation in decision-making than desired more frequently had compulsory admissions. We propose to assess participation preferences each time a relevant treatment decision is about to be made and tailor care accordingly. We identified several factors leading to compulsory admissions that can be modified to prevent further coercive measures.
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Affiliation(s)
- Inés Morán-Sánchez
- Mental Health Centre, Health Service of Murcia, CSM Cartagena, Calle Real, 8, 30201, Murcia, Spain.
| | - María A Bernal-López
- Mental Health Centre, Health Service of Murcia, CSM Cartagena, Calle Real, 8, 30201, Murcia, Spain
| | - Maria D Pérez-Cárceles
- Department of Legal and Forensic Medicine, Faculty of Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, Murcia, Spain
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Morán-Sánchez I, Gómez-Vallés P, Bernal-López MÁ, Pérez-Cárceles MD. Shared decision-making in outpatients with mental disorders: Patients´ preferences and associated factors. J Eval Clin Pract 2019; 25:1200-1209. [PMID: 31373107 DOI: 10.1111/jep.13246] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/11/2019] [Accepted: 07/16/2019] [Indexed: 01/21/2023]
Abstract
RATIONALE, AIMS AND OBJECTIVES Over the last years, traditional paternalistic model is being questioned. Shared Decision-Making (SDM) model has been proposed as a way to improve patient-physician interaction. Little is known to what extent people with severe mental illness want to be involved in decision-making process. This study evaluates their preferences about making clinical decisions and which variables influence these desires. METHOD One hundred seven patients with DSM diagnoses of bipolar disorder or schizophrenia and 100 Non Psychiatric Comparison (NPC) subjects recruited from mental health and primary care departments completed a self-reported questionnaire about preferences in decision-making process. Demographic and clinical information was obtained through review of available records and the Brief Psychiatric Rating Scale (BPRS). RESULTS Patients and NPCs differed as regards their preferences about their participation in medical decisions. NPCs were 18 times more likely to prefer options about their treatment and 2 times more likely to prefer to take medical decisions by their own than psychiatric patients. The best predictors of the preference of a SDM model were a lower BPRS global score and the absence of previous compulsory admissions. CONCLUSIONS Psychiatric patients more frequently preferred a passive role in the decision-making process. Interventions to promote SDM should be tailored to the values and needs of each patient because not everyone wants to participate to the same degree. We found several factors to take into account in patient engagement in SDM as these populations may be more vulnerable.
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Affiliation(s)
| | - Paula Gómez-Vallés
- Department of Legal Medicine, Regional Campus of International Excellence "Campus Mare Nostrum," Faculty of Medicine, University of Murcia, Cartagena, Spain
| | | | - María Dolores Pérez-Cárceles
- Department of Legal Medicine, Regional Campus of International Excellence "Campus Mare Nostrum," Faculty of Medicine, University of Murcia, Cartagena, Spain
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Morán-Sánchez I, Luna A, Pérez-Cárceles MD. Willingness of patients with SUD to participate in research: prevalence and associated factors. Adicciones 2019; 31:95-105. [PMID: 30059576 DOI: 10.20882/adicciones.960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Greater attention is focusing on the motivations of subjects recruited for research protocols, especially in vulnerable populations. Although addiction is a highly stigmatized condition, very little research has focused on the factors influencing the decision to participate of patients with an addiction. Our aim is to gather further evidence in relation to the motivations of people with Substance Use Disorders (SUD), comparing their reasoning and willingness to participate in a hypothetical research study of 53 subjects with DSM-5 diagnoses of SUD and 50 controls. Responses on the MacArthur Competence Assessment Tool for Clinical Research were documented and correlated with several variables. There were no significant differences in willingness to participate in research and reasons for doing so between SUD and controls. Among SUD subjects, 59% mentioned altruism, 53.8% expected therapeutic benefits, and 43.6% desired to help others; none mentioned money. Of those patients with SUD who refused to participate in research, 69.2% cited aversion and 46.2% mentioned risk. Willingness to participate was correlated with higher computer literacy and better cognitive performance. In the multivariate analysis, aversion was a significant predictor of willingness to participate in research. When research is not related to their diagnosis, the motivations of SUD and controls are similar and flowed logically from the study. However, elements associated with therapeutic misconceptions were also evident. Therefore, negative views about the motivations of SUD subjects' participation in research are unfounded. Consequently, to improve study recruitment, assessments may be targeted to specific vulnerabilities rather than to diagnoses.
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Morán-Sánchez I, Maurandi-López A, Pérez-Cárceles MD. Assessment of Motivations and Willingness to Participate in Research of Outpatients With Anxiety, Mood, and Psychotic Disorders. J Empir Res Hum Res Ethics 2018; 13:546-560. [PMID: 30047823 DOI: 10.1177/1556264618789564] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The motivations of participants recruited for research, especially from potentially vulnerable populations, have received increasing attention. The present investigation compares the motivations and willingness to participate in research of 134 psychiatric outpatients and 50 controls. The willingness to participate of both groups was similar. We found a higher proportion of psychiatric admissions and a higher degree of computer literacy among those willing to participate. Regardless of their decision concerning participation, the reasons given by the members of both groups were logical and concordant with the related literature. This suggests that negative views about the motivations of psychiatric patients to act as research participants are unfounded. Efforts should focus on the predictors of willingness to participate that we have identified for improving recruitment. The implications of these results for research are discussed.
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Morán-Sánchez I, Luna A, Pérez-Cárceles MD. Assessing the decision-making capacity of the addicted population to take part in research: myths, barriers, and benefits. Adicciones 2017; 29:213-214. [PMID: 28492963 DOI: 10.20882/adicciones.938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Letter to the editor.
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Abstract
Mental capacity is an emerging ethical legal concept in psychiatric settings but its relation to clinical parameters remains yet uncertain. The aim of this study is to evaluate the association between capacity to consent research and different psychiatric disorders and to characterize predictors of impairments in research decision-making capacity across diagnostic groups in a cross-sectional study. 139 consecutively referred outpatients with DSM-IV TR diagnoses of psychotic, mood and anxiety disorders were interviewed and a binary judgment of incapacity was made guided by the MacArthur competence assessment tool for consent research (MacCAT-CR). Demographics and clinical information were assessed by cases notes. Patients with anxiety disorders performed the best on the MacCAT-CR, and patients with psychotic disorders had the worst performance, however, there was considerable heterogeneity within each group. Cognitive impairment and global functioning were strongly correlated with MacCAT-CR subscales scores. 30.6% participants lacked research-related decisional capacity. Low Understanding score OR 0.07 (IC 95% 0.01-0.32) and Low Reasoning score OR 0.30 (IC 95% 0.11-0.82) were the factors most closely associated with lack of capacity. No absolute statements about decisional capacity can be driven merely due to the diagnosis. We found several risk factors which may be considered to decide which populations may require more thorough capacity assessments. The issues under consideration in the present study are by no means unique to people with psychiatric conditions. Ignoring this caveat, risks further inappropriate stigmatization of those with serious mental illness.
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Affiliation(s)
- Inés Morán-Sánchez
- Mental Health Centre, Health Service of Murcia, 30201, Cartagena, Murcia, Spain.
| | - Aurelio Luna
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence "Campus Mare Nostrum", Faculty of Medicine, University of Murcia, Murcia, Spain
| | - Maria D Pérez-Cárceles
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence "Campus Mare Nostrum", Faculty of Medicine, University of Murcia, Murcia, Spain
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Morán-Sánchez I, Luna A, Sánchez-Muñoz M, Aguilera-Alcaraz B, Pérez-Cárceles MD. Decision-making capacity for research participation among addicted people: a cross-sectional study. BMC Med Ethics 2016; 17:3. [PMID: 26759171 PMCID: PMC4710992 DOI: 10.1186/s12910-015-0086-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 12/23/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Informed consent is a key element of ethical clinical research. Addicted population may be at risk for impaired consent capacity. However, very little research has focused on their comprehension of consent forms. The aim of this study is to assess the capacity of addicted individuals to provide consent to research. METHODS 53 subjects with DSM-5 diagnoses of a Substance Use Disorder (SUD) and 50 non psychiatric comparison subjects (NPCs) participated in the survey from December 2014 to March 2015. This cross-sectional study was carried out at a community-based Outpatient Treatment Center and at an urban-located Health Centre in Spain. A binary judgment of capacity/incapacity was made guided by the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR) and a clinical interview. Demographics and clinical characteristics were assessed by cases notes and the Mini-Mental State Examination, the Global Assessment Functional Scale and the Clinical Global Impression Scale. RESULTS NPCs performed the best on the MacCAT-CR, and patients with SUD had the worst performance, particularly on the Understanding and Appreciation subscales. 32.7% SUD people lacked research-related decisional capacity. There were no statistically significant differences between the groups in terms of capacity to consent to research. CONCLUSIONS The findings of our study provide evidence that a large proportion of individuals with SUD had decisional capacity for consent to research. It is therefore inappropriate to draw conclusions about capacity to make research decisions on the basis of a SUD diagnosis. In the absence of advanced cognitive impairment, acute withdrawal or intoxication, we should assume that addicted persons possess decision-making capacity. Thus, the view that people with SUD would ipso facto lose decision-making power for research consent is flawed and stigmatizing.
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Affiliation(s)
- Inés Morán-Sánchez
- Mental Health Centre (Health Service of Murcia), Real St 8, E-30201, Cartagena (Murcia), Spain.
| | - Aurelio Luna
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence "Campus Mare Nostrum", Faculty of Medicine, University of Murcia, (Murcia), Spain.
| | - Maria Sánchez-Muñoz
- Mental Health Centre (Health Service of Murcia), Real St 8, E-30201, Cartagena (Murcia), Spain.
| | - Beatriz Aguilera-Alcaraz
- Isaac Peral Health Centre (Health Service of Murcia), Ulloa St 6. E 30300, Cartagena (Murcia), Spain.
| | - Maria D Pérez-Cárceles
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence "Campus Mare Nostrum", Faculty of Medicine, University of Murcia, (Murcia), Spain.
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Navarro-Mateu F, Morán-Sánchez I, Alonso J, Tormo MJ, Pujalte ML, Garriga A, Aguilar-Gaxiola S, Navarro C. Cultural adaptation of the Latin American version of the World Health Organization Composite International Diagnostic Interview (WHO-CIDI) (v 3.0) for use in Spain. Gac Sanit 2012; 27:325-31. [PMID: 22842058 DOI: 10.1016/j.gaceta.2012.06.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 06/03/2012] [Accepted: 06/18/2012] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To develop a Spanish version of the WHO-Composite International Diagnostic Interview (WHO-CIDI) applicable to Spain, through cultural adaptation of its most recent Latin American (LA v 20.0) version. METHODS A 1-week training course on the WHO-CIDI was provided by certified trainers. An expert panel reviewed the LA version, identified words or expressions that needed to be adapted to the cultural or linguistic norms for Spain, and proposed alternative expressions that were agreed on through consensus. The entire process was supervised and approved by a member of the WHO-CIDI Editorial Committee. The changes were incorporated into a Computer Assisted Personal Interview (CAPI) format and the feasibility and administration time were pilot tested in a convenience sample of 32 volunteers. RESULTS A total of 372 questions were slightly modified (almost 7% of approximately 5000 questions in the survey) and incorporated into the CAPI version of the WHO-CIDI. Most of the changes were minor - but important - linguistic adaptations, and others were related to specific Spanish institutions and currency. In the pilot study, the instrument's mean completion administration time was 2h and 10min, with an interquartile range from 1.5 to nearly 3h. All the changes made were tested and officially approved. CONCLUSIONS The Latin American version of the WHO-CIDI was successfully adapted and pilot-tested in its computerized format and is now ready for use in Spain.
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Affiliation(s)
- Fernando Navarro-Mateu
- Unidad de Docencia, Investigación y Formación en Salud Mental UDIF-SM, Subdirección General de Salud Mental y Asistencia Psiquiátrica, Servicio Murciano de Salud, Murcia, Spain.
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