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The COVID-19 pandemic has had a serious impact on the mental health of the population, which also has been affected by various barriers to access to psychological care. The aim of the current study is to compare the mental health status of the Spanish population between the onset of confinement (N = 3480) to 12 months later (N = 550), and to describe the use of psychological care services and the main barriers to access. Study participants completed an online survey. Forty percent of the sample reported experiencing a mental health problem since the pandemic's onset, of which 23.4% reported having received some kind of care. The majority reported not seeking care because they could handle the problems on their own, their problems got better on their own, or they could not afford treatment. The psychological effects of the pandemic have been increasing since its onset, so attention to mental health problems should be a priority.
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Introduction: eHealth programs is an emerging area because of the restricted measures for controlling COVID19 pandemic a such as avoiding close contact or group activities, especially indoor. For these reasons, Spanish Cancer Association of Madrid (AECCmad), transformed all exercise-oncology programs into online version with the objective of maintaining the exercise attention to the breast cancer patients (BCP). This shows the first results from this adapted intervention, evaluating the effectiveness in physical outcomes as well as the feasibility of the new model. Methodology: Since 1st of September of 2020 a total of 64 patients with breast cancer (BC) in different stages were attended in the exercise-oncology unit of the AECCmad using the online model. Firstly, a specialized nurse checked that all patients fulfilled the inclusion criteria to ensure BCP safeness. After this, all women had a one-to-one interview with the exercise-oncology professionals, face-to-face (F-F) or online, where anthropometrics (weight and high in virtual and bioimpedance in F-F interview) and functional capacity (6 minutes walking test, sit and stand in online interview, and that two as well as cardiorespiratory fitness, maximal strength and bioimpedance in F-F interview) were assessed to individualized exercise interventions. Then, BCP were enrolled in a 8-weeks online program adapted to their characteristics, where a specialist in Sexercise-oncology supervised each session, performing a combined exercise intervention from 50 to 90% of maximal heart rate. At the end, a final assessment was carried out with a twofold purpose: to inform patients of the achieved changes and to give them a personalized final report that would help women to continue exercising. Adherence of the program and physical variables collected in pre-post tests were analyzed. T test of related samples were used to compare pre-post assessments. Results 59 BCP with a mean of 45.7(10.03) years old completed the online program: 31.3% were survivors, 56.7% were under treatment and 12.5% had metastatic disease and 59% of the women had a F-F assessment, while the 41% were online. Related to the feasibility, program adherence was 92.2% (only 5 patients doped out the program) and classes assistance rate was 81%. BCP showed significant improvements in cardiorespiratory fitness (DifMean (ΔM): 8.56 ml.kg.min;CI95% 5.76-11.37;p=0.0001), strength in upper limbs (DifMean:11.38 kg;CI95%: 8.97-13.79;p=0.0001), and in legs (ΔM: 29.37 kg;CI95%: 23.93-34.82;p=0.0001) and in sit and stand test (ΔM: 4.53 squats;CI95%: 2.19-6.88;p=0.0001);and almost significant in distance of six minutes walking test (ΔM: 76.70 meters;CI95%:-4.80-158.21;p=0.064) Conclusions: Exercise-oncology online programs adapted to BCP characteristics are feasible and effective to significantly improve cardiorespiratory fitness and functional capacity. In addition, this type of programs might be a useful tool to achieve a healthy balance in BCP's body composition. This new model of intervention not only presents high levels of adherence, but also, allows patients to access supervised exercise programs that otherwise would not be possible. Online intervention in exercise oncology might be a feasible, safe, and effective tool not only to improve BCP's health but also for other cancer patients, in any stage of cancer.
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The aim of the study is to longitudinally analyse the effects of confinement derived from COVID-19 on the loneliness of the general Spanish population. It was assessed by an online survey at three points in time: two weeks after the start of confinement (N = 3480), one month after (N = 1041) and two months after the return to normal (N = 569). Measures were taken of sociodemographic variables, loneliness, social support, depressive and anxious symptoms. To analyse the effect of the longitudinal measures, a mixed linear model (GLMM) was calculated for the solitude variable. Posthoc comparisons for the time variable were calculated using the marginal means estimated with Tuckey's correction. The analyses have been carried out using the R software (v3.5.6) and the lme4 and emmeans packages. The trend in loneliness scores is downward throughout the longitudinal study, decreasing the scores in the third evaluation significantly (Z((T1-T2)) = 0.13, p =.045). The main predictors for loneliness are depressive symptomatology and social support. Greater attention needs to be paid to loneliness in these situations, in addition to presenting attention to associated depressive symptomatology and measures to strengthen social support networks in these circumstances.
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Background: As of the 25th of January 2021, more than 150 thousand deaths as consequence of COVID-19 have been reported in Mexico [1]. Advanced age, male gender and comorbidities have been described as risk factors for severe disease and mortality in general population [2]. COVID-19 mortality in Mexican patients with rheumatic and musculoskeletal diseases (RMDs) is unknown. Objectives: To describe characteristics of Mexican patients with RMDs and COVID-19, and to analyse factors associated with mortality. Methods: The Global Rheumatology Alliance COVID-19 (GRA) physician reported registry, is an international effort to collect information on COVID19 in adult patients with RMDs. GRA is an observational registry. The first patient from Mexico was registered on April 17, 2020. All Mexican patients registered in GRA until October 30, 2020 were included in this analysis. The association of mortality with demographic and clinical variables was estimated using logistic regression analysis. Results: A total of 323 patients were registered, with a median age of 52 (IQR 41-61) years old, 166 (51.4%) patients lived in Mexico City. The most frequent RMDs were rheumatoid arthritis, 149 (46.1%) and systemic lupus erythematosus, 24 (19.8%). Over a third of patients with RMDs and COVID-19 (119 (36.8%)) were hospitalized, and 43 (13.3%) died. Table 1 shows clinical and demographic characteristics. In the univariable analysis, the absence of comorbidities was a protective factor, OR 0.3 (95% CI 0.1-0.6). Factors associated with mortality at COVID-19 diagnosis were age over 65 years old, having type 2 diabetes, chronic renal insufficiency, treatment at COVID-19 diagnosis with corticosteroids or with CD20 inhibitors. In the multivariable adjusted analysis, these factors remained independently associated with mortality. No associations with other treatments or comorbidities at COVID-19 diagnosis were found. Conclusion: Mexican patients with RMDs and COVID-19 in the GRA physician reported registry had a mortality of 13.3%. Factors associated with mortality were those described in the general population, such as older age and being on corticosteroids and CD20 inhibitors treatment at COVID-19 diagnosis.
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AIMS: The objective is to conduct a longitudinal analysis of the effects of the pandemic and alarm situation on the mental health of the general population at three points in time: two weeks after beginning the confinement, after a month, and after two months, when the lockdown was lifted and the country returned to the new normality. METHODS: The evaluations were carried out by means of an online survey, with a sample of 3480 persons in the first data collection and 1041 and 569 persons in the successive evaluation periods. The presence of depressive symptoms, anxiety and posttraumatic stress disorder (PTSD) was evaluated by means of screening tests. Sociodemographic data, Covid-19 variables, loneliness, psychological well-being, social support, discrimination and a sense of belonging, were collected. RESULTS: Depressive symptoms increased significantly throughout the confinement, decreasing at the last assessment but not dropping to previous levels. In anxiety, there are no significant changes between the three evaluations, but a downward trend can be seen over time. Regarding the symptomatology of PTSD, a downward trend is observed throughout the three evaluations, with significantly lower scores between the first and third assessments. The different regression models developed reveal the importance of perceived loneliness and spiritual well-being as the main predictors of mental health, as well as the importance of the lower age for depression and the female gender for anxiety and PSTD. CONCLUSIONS: This research shows that the pandemic has had a negative impact on our mental health, which still does not seem to be at pre-crisis levels, although it has improved as the emergency situation subsides. These results underline the importance of paying greater attention to mental health, and reveal key variables such as spiritual well-being and perceived loneliness in which to intervene from different care services, as well as younger people and women as vulnerable groups on which to focus more attention.
Subject(s)
COVID-19/epidemiology , COVID-19/psychology , Mental Health/trends , Quarantine/psychology , Quarantine/trends , Stress, Psychological/epidemiology , Stress, Psychological/psychology , Adolescent , Adult , Disease Outbreaks , Female , Humans , Loneliness/psychology , Longitudinal Studies , Male , Middle Aged , Social Support , Spain/epidemiology , Surveys and Questionnaires , Young AdultABSTRACT
INTRODUCTION: The COVID-19 pandemic will give rise to long-term changes in neurological care, which are not easily predictable. MATERIAL AND METHODS: A key informant survey was used to enquire about the changes expected in the specialty over the next 5 years. The survey was completed by heads of neurology departments with broad knowledge of the situation, having been active during the pandemic. RESULTS: Despite a low level of consensus between participants, there was strong (85%) and moderate consensus (70%) about certain subjects, mainly the increase in precautions to be taken, the use of telemedicine and teleconsultations, the reduction of care provided in in-person consultations to avoid the presence of large numbers of people in waiting rooms, the development of remote training solutions, and the changes in monitoring visits during clinical trials. There was consensus that there would be no changes to the indication of complementary testing or neurological examination. CONCLUSION: The key informant survey identified the foreseeable changes in neurological care after the pandemic.