ABSTRACT
The aim was to assess the impact of neighborhood physical environment on mental health among non-institutionalized older adults. A cross-sectional analysis was conducted over a representative sample of 5,071 people ≥65 years from the Spanish National Health Survey. The survey included nine items addressing the self-perceived degree of discomfort due to neighborhood physical problems. Participants were categorized into groups with "no problems", "some problems" (somewhat discomfort on 1-4 items) and "many problems" (somewhat discomfort on ≥5 items or very much discomfort on ≥1 item). Mental health status was assessed using the General Health Questionnaire, consisting of 12 items assessing the severity of a psychological distress over the past few weeks. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regressions. A dose-response association (p-trend<0.001) was found between living in neighborhoods with some (OR: 1.41; 95% CI: 1.14-1.75) or many problems (OR: 1.93; 95% CI: 1.55-2.42) affecting the physical environment with poor mental health of community dwelling older adults. Integrating and articulating health considerations into public policymaking regarding housing and the residential environment can have broad implications for healthy aging.
Subject(s)
Mental Health , Residence Characteristics , Humans , Aged , Cross-Sectional Studies , Spain , Independent LivingABSTRACT
OBJECTIVE: Civil Guards are deployed throughout Spain and susceptible to being the first responders in out-of-hospital cardiorespiratory arrest. However, their level of training to perform Basic Life Support (BLS) is unknown. The aim of this work was to evaluate the level of knowledge on BLS of Civil Guards, and to explore the association between periodicity of training and knowledge. METHODS: Cross-sectional study of 839 Civil Guards in Asturias (Spain). A questionnaire with 14 multiple-choice questions assessed knowledge on cardiopulmonary resuscitation (CPR) and use of automatic defibrillator, which were transferred to 0-10 points scales (higher score indicted higher knowledge). Multiple linear regressions were used to estimate mean knowledge scores according to training on BLS (never, >2 years ago and ≤2 years ago), adjusted by sociodemographic and occupational variables. RESULTS: Around 1 out of 10 Civil Guards performed some real CPR (11.2%). Regarding training, 42.5% had never participated in courses and 33.4% were trained >2 years ago. There was a discordance between willingness to perform BLS (65.6%) and self-perception of preparation (21.8%). A dose-response association was detected between training periodicity and knowledge: 4.26 points (95% CI: 4.07-4.45) of those never formed, 5.93 (95% CI: 5.71-6, 15) of those trained >2 years ago, 7.18 (95% CI: 6.92-7.44) of those trained ≤2 years ago (p-trend <0.001). CONCLUSIONS: The level of training and knowledge on BLS of the Civil Guards is low. Receiving training every two years is significantly associated with greater knowledge.
OBJETIVO: La Guardia Civil es un cuerpo desplegado por toda España y susceptible de ser el primer interviniente en paradas cardiorrespiratorias extrahospitalarias. Sin embargo, se desconoce su nivel de capacitación para realizar Soporte Vital Básico (SVB). El objetivo de este estudio fue estimar el nivel de conocimientos de los guardias civiles sobre SVB y determinar si la periodicidad de la formación se asociaba con los conocimientos. METODOS: Se realizó un estudio transversal con una muestra de 839 guardias civiles de Asturias. Un cuestionario de 14 preguntas de opción múltiple evaluó los conocimientos sobre resucitación cardiopulmonar (RCP) y uso del desfibrilador automático, que se trasladaron a escalas de 0-10 puntos (más puntos indicaron más conocimientos). Se utilizaron regresiones lineales múltiples para estimar las puntuaciones medias de conocimientos según la formación en SVB (nunca, hace más de 2 años y menor o igual a 2 años), ajustadas por variables sociodemográficas y profesionales. RESULTADOS: El 11,2% de los guardias civiles había realizado alguna RCP real. El 42,5% nunca había recibido formación y el 33,4% hace más de 2 años. Encontramos discordancia entre la disposición para realizar SVB (65,6%) y la sensación de estar adecuadamente preparado (21,8%). Se detectó asociación dosis-respuesta entre la periodicidad de la formación y los conocimientos: 4,26 puntos (IC95%: 4,07-4,45) de los nunca formados; 5,93 (IC95%: 5,71-6,15) de los formados hace más de 2 años; 7,18 (IC95%: 6,92-7,44) de los formados hace menos o igual a 2 años (p-tendencia<0,001). CONCLUSIONES: El nivel de formación y conocimientos sobre SVB de los guardias civiles es bajo. Recibir formación cada dos años se asocia significativamente con mayores conocimientos.
