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1.
J Med Ethics ; 48(7): 472-478, 2022 07.
Article in English | MEDLINE | ID: covidwho-1226765

ABSTRACT

A public health emergency, as the COVID-19 pandemic, may lead to shortages of potentially life-saving treatments. In this situation, it is necessary, justifiable and proportionate to have decision tools in place to enable healthcare professionals to triage and prioritise access to those resources. An ethically sound framework should consider the principles of beneficence and fair allocation. Scientific Societies across Europe were concerned with this problem early in the pandemic and published guidelines to support their professionals and institutions. This article aims to compare triage policies from medical bodies across Europe, to characterise the process of triage and the ethical values, principles and theories that were proposed in different countries during the first outbreak of COVID-19.


Subject(s)
COVID-19 , Disease Outbreaks , Health Care Rationing , Humans , Pandemics , SARS-CoV-2 , Societies, Scientific , Triage
2.
Am J Geriatr Psychiatry ; 28(12): 1287-1298, 2020 12.
Article in English | MEDLINE | ID: covidwho-746015

ABSTRACT

OBJECTIVE: Main aims of the study are to examine the early psychological correlates associated with the COVID-19 pandemic and lockdown on the mental health of a Spanish older adult sample and to analyze the influence of past mental disorder (PMD) and current mental disorder (CMD) on those correlates. METHODS: Cross-sectional study based on an online snowball recruiting questionnaire. Psychological correlates assessed with the Depression, Anxiety, and Stress Scale (DASS-21) and Impact of Event Scale (IES). Binary and multinomial logistic regression models were used to identify risk and protective factors. RESULTS: Final sample included 2,194 individuals aged 60 years or more (mean age [SD]: 65.62 [5.05]; females: 1,198 [54.6%]). There were 342 (15.6%) individuals who reported a PMD and 162 (7.4%) who reported a CMD. Avoidant (32.1%) and depressive (25.6%) styles were the most prevalent, regardless of mental health status. Main risk factors for negative affectivity were female gender and history CMD or PMD. However, job stability and the ability to enjoy free time were generally associated with better outcomes. No differences were found in psychological correlates between those with no lifetime history of mental disorder versus PMD on the DASS-21 or IES. However, CMD was associated with higher anxiety scores on the DASS-21 (odds ratio: 1.838, p < .001). CONCLUSION: Regardless of mental status, avoidant and depressive styles were the most prevalent in this older adult sample. Main protective factor in all subgroups was the ability to enjoy free time, whereas the main risk factors were being female and current or past history of mental disorder.


Subject(s)
Avoidance Learning , Coronavirus Infections , Depression , Mental Disorders/epidemiology , Mental Health/trends , Pandemics , Pneumonia, Viral , Stress, Psychological , Aged , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Cross-Sectional Studies , Depression/diagnosis , Depression/epidemiology , Female , Humans , Male , Medical History Taking , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , Prevalence , Protective Factors , Risk Factors , SARS-CoV-2 , Spain/epidemiology , Stress, Psychological/epidemiology , Stress, Psychological/etiology , Stress, Psychological/prevention & control
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