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1.
Article in English | MEDLINE | ID: mdl-36430033

ABSTRACT

BACKGROUND: This study aimed to compare well-being and physical activity (PA) before and during COVID-19 confinement in older adults with heart failure (HF), to compare well-being and PA during COVID-19 confinement in octogenarians and non-octogenarians, and to explore well-being, social support, attention to symptoms, and assistance needs during confinement in this population. METHODS: A mixed-methods design was performed. Well-being (Cantril Ladder of Life) and PA (International Physical Activity Questionnaire) were assessed. Semi-structured interviews were performed to assess the rest of the variables. RESULTS: 120 participants were evaluated (74.16 ± 12.90 years; octogenarians = 44.16%, non-octogenarians = 55.83%). Both groups showed lower well-being and performed less PA during confinement than before (p < 0.001). Octogenarians reported lower well-being (p = 0.02), higher sedentary time (p = 0.03), and lower levels of moderate PA (p = 0.04) during confinement. Most individuals in the sample considered their well-being to have decreased during confinement, 30% reported decreased social support, 50% increased their attention to symptoms, and 60% were not satisfied with the assistance received. Octogenarians were more severely impacted during confinement than non-octogenarians in terms of well-being, attention to symptoms, and assistance needs. CONCLUSIONS: Well-being and PA decreased during confinement, although octogenarians were more affected than non-octogenarians. Remote monitoring strategies are needed in elders with HF to control health outcomes in critical periods, especially in octogenarians.


Subject(s)
COVID-19 , Heart Failure , Humans , Aged , Aged, 80 and over , COVID-19/epidemiology , Social Support , Heart Failure/therapy , Exercise , Sedentary Behavior
2.
Article in English | MEDLINE | ID: mdl-35682344

ABSTRACT

EhcoBUTLER is a tablet platform mainly aimed at the elderly with mild cognitive impairment (MCI) to promote their well-being and health. The main objective of this study was to explore the perceptions and feedback level of the ehcoBUTLER potential users and stakeholders to improve its development. Through this exploration, the secondary objective was to contribute to the development of software/apps that promote their integral health. Focus groups were conducted (13 elderly with MCI, 13 with dementia, 12 caregivers, 11 professionals). The content and feedback level were analyzed. Participants liked the appearance of ehcoBUTLER, would like to use it, and were mainly interested in the emotional, healthy lifestyle, cognitive, and ergonomic tools. It is necessary to have prior training, more intuitive/customizable apps, low-price/free, offline/USB content, and add other activities/features. EhcoBUTLER is well-oriented to meet the needs and preferences of potential users. However, improvements in its usability, accessibility, and sustainability are needed. The participants' perspectives provided a comprehensive view to improve ehcoBUTLER, so that in the future, it can benefit the elderly to be active agents in their health; support caregivers in their role and to have a respite; and professionals to have a multi-intervention platform. The present findings can contribute to the development of tablet software/apps that promote the integral well-being of this population.


Subject(s)
Cognitive Dysfunction , Dementia , Aged , Caregivers/psychology , Cognitive Dysfunction/psychology , Delivery of Health Care , Dementia/psychology , Focus Groups , Humans , Tablets
3.
Autism ; 26(8): 2136-2150, 2022 11.
Article in English | MEDLINE | ID: mdl-35261293

ABSTRACT

LAY ABSTRACT: Professional guidance and support in response to first concerns appears to be an important predictor of the level of satisfaction with the detection process of autism in young children. In this study, we analyzed the views of 1342 family members, including 1278 parents, who completed an online survey form collecting information about their experience and satisfaction with the early detection of autism in their child. Specifically, we were interested in how specific experiences with the detection process relate to the satisfaction with it and whether we could identify important predictors of satisfaction. The detection process is an emotionally charged period for parents, often described as painful, chaotic, and lengthy. A better understanding of their experiences is important to take appropriate action to improve the detection process. In our sample, the level of satisfaction with the detection process varied greatly from one respondent to another. Among the different experiences we considered, whether or not respondents received professional guidance and support in response to first concerns explained most of this variation. We also found that difficulty finding information about detection services, lack of professional guidance and support in response to first concerns, having to find a diagnostic service on one's own, and longer delays between confirmation of concerns and first appointment with a specialist were experiences associated with a greater likelihood of being unsatisfied. The findings of this study highlight the importance of the parent-professional relationship in the detection process and have important practical implications for health administrations to improve the detection process.


Subject(s)
Autism Spectrum Disorder , Autistic Disorder , Child , Humans , Child, Preschool , Autistic Disorder/diagnosis , Autistic Disorder/psychology , Personal Satisfaction , Autism Spectrum Disorder/diagnosis , Autism Spectrum Disorder/psychology , Parents/psychology , Family
4.
Article in English | MEDLINE | ID: mdl-33806158

ABSTRACT

There is evidence supporting the use of psychosocial interventions in dementia care. Due to the role of policy in clinical practice, the present study investigates whether and how the issue of psychosocial care and interventions has been addressed in the national dementia plans and strategies across Europe. A total of 26 national documents were found. They were analyzed by content analysis to identify the main pillars associated with the topic of psychosocial care and interventions. Specifically, three categories emerged: (1) Treatment, (2) Education, and (3) Research. The first one was further divided into three subcategories: (1) Person-centred conceptual framework, (2) Psychosocial interventions, and (3) Health and social services networks. Overall, the topic of psychosocial care and interventions has been addressed in all the country policies. However, the amount of information provided differs across the documents, with only the category of 'Treatment' covering all of them. Furthermore, on the basis of the existing policies, how the provision of psychosocial care and interventions would be enabled, and how it would be assessed are not fully apparent yet. Findings highlight the importance of policies based on a comprehensive and well-integrated system of care, where the issue of psychosocial care and interventions is fully embedded.


Subject(s)
Dementia , Psychiatric Rehabilitation , Caregivers , Dementia/therapy , Europe , Humans , Social Work
5.
Comput Educ ; 168: 104212, 2021 Jul.
Article in English | MEDLINE | ID: mdl-36568577

ABSTRACT

In the information and knowledge society, where technology develops rapidly and penetrates deeply into our lives, the discussion about digital competence has become a hot topic today. After the emergence of the Coronavirus (Covid-19) and with its huge impact on the education industry, the concern about digital competence has reached a new height. This systematic literature review uses Web of science and Scopus as databases to store and analyze the existing research on digital competence in higher education settings. The purpose of this review is to provide the scholar community with a current overview of digital competence research from 2015 to 2021 in the context of higher education regarding the definition of digital competence, dimensions used to evaluate digital competence, research purposes, methodologies, and results and limitations. Major findings include that the majority of publications cited both research and EU policy in describing the definition of digital competence. The review indicates that most university students and teachers have a basic level of digital competence. Besides, the institutions of higher education are encouraged to focus on the development students and teachers' digital competence, create relevant learning strategies and use appropriate tools to improve the quality of education.

6.
Rev. Asoc. Esp. Espec. Med. Trab ; 29(2): 40-45, jun. 2020. tab
Article in Spanish | IBECS | ID: ibc-193753

ABSTRACT

OBJETIVO: Identificar factores que influyen en la duración de la prestación por riesgo durante el embarazo en las trabajadoras del ámbito sanitario. Material y MÉTODOS: Estudio descriptivo y transversal. Se estudiaron las trabajadoras embarazadas del SNS- O, que notificaron su gestación desde 01 enero de 2017 hasta 31 diciembre de 2018. Las variables fueron: centro de trabajo, profesión, tipo de contrato, tipo de guardias, y su relación con la duración de la prestación por riesgo durante el embarazo. RESULTADOS: 536 trabajadoras notificaron su embarazo, pero se excluyeron 86, por no disponer de la variable "duración de la prestación". El análisis de los datos mostró una p > 0,05 en todos los contrastes de hipótesis, excepto en la relación entre duración de prestación y guardias presenciales vs localizadas (p = 0,052). CONCLUSIONES: Ligera asociación entre las guardias presenciales vs localizadas y los días de suspensión del contrato de trabajo por riesgo durante el embarazo


OBJECTIVE: To identify factors that influence the duration of the risk during pregnancy benefit in female health workers. MATERIAL AND METHODS: Descriptive and cross-sectional study. The pregnant workers studied were the ones who notified their gestation grom January 1, 2017 to December 31, 2018 of the SNS-O. The variables collected were: work center, profession, type of contract, type of guards, and their relationship with the duration of the risk benefit during pregnancy. RESULTS: 536 workers notified their pregnancy, but 86 were excluded, because they did not have the variable "duration of benefit". The analysis of the data showed a p> 0.05 in all hypothesis contrasts, except in the relationship between benefit duration and presence vs localized guards (p =0.052). CONCLUSIONS: Slight association between presence vs localized guards and the days of suspension of the employment contract due to risk during pregnancy


Subject(s)
Humans , Female , Pregnancy , Health Personnel/statistics & numerical data , Occupational Exposure/prevention & control , Health Personnel/classification , Occupational Health/statistics & numerical data , Cross-Sectional Studies , Risk Factors , Risk Groups
7.
Dementia (London) ; 19(5): 1474-1491, 2020 Jul.
Article in English | MEDLINE | ID: mdl-30253659

ABSTRACT

In the growing body of literature dealing with the consequences of family caregiving amongst people with dementia, there are few studies examining the impact of Early-onset Familial Alzheimer's Disease on caregivers. This study exposes the subjective experience of a group of family caregivers who themselves possess a genetic susceptibility to develop this form of dementia. We interviewed and analyzed the accounts of 27 caregivers belonging to family lineages carrying the E280A mutation for Early-onset Alzheimer's Disease. We utilized a phenomenological method to analyze these accounts, initially tracking seven theoretical categories (Anxiety, Depression, Burden, Resilience, Self-efficacy, Social Support, and Coping Strategies) and then subsequently two additional categories which emerged (Conceptions about the Disease and Other Vital Experiences Interfering with Caregiving). The results show that caring for a loved one while simultaneously running the risk of developing the same form of Alzheimer's Disease permeates the caregivers' experience both in a negative and a positive way. The continuous exposition to emotional stress in these caregivers should be seriously considered as they may be at risk of accelerating the onset of symptoms of Alzheimer's Disease, while simultaneously, early psychological symptoms of dementia may be masked by the emotional sequelae of caregiving, interfering with early diagnosis. Certainly, support services for the entire family group are suggested.


Subject(s)
Adaptation, Psychological , Alzheimer Disease/genetics , Caregivers/psychology , Narration , Resilience, Psychological , Stress, Psychological/psychology , Adult , Female , Humans , Interviews as Topic , Male , Middle Aged , Mutation/genetics , Social Support
8.
J Autism Dev Disord ; 50(9): 3380-3394, 2020 Sep.
Article in English | MEDLINE | ID: mdl-31606886

ABSTRACT

Early services for ASD need to canvas the opinions of both parents and professionals. These opinions are seldom compared in the same research study. This study aims to ascertain the views of families and professionals on early detection, diagnosis and intervention services for young children with ASD. An online survey compiled and analysed data from 2032 respondents across 14 European countries (60.9% were parents; 39.1% professionals). Using an ordinal scale from 1 to 7, parents' opinions were more negative (mean = 4.6; SD 2.2) compared to those of professionals (mean = 4.9; SD 1.5) when reporting satisfaction with services. The results suggest services should take into account child's age, delays in accessing services, and active stakeholders' participation when looking to improve services.


Subject(s)
Autism Spectrum Disorder/psychology , Early Intervention, Educational/standards , Health Knowledge, Attitudes, Practice , Autism Spectrum Disorder/rehabilitation , Autism Spectrum Disorder/therapy , Child , Child, Preschool , Early Diagnosis , Early Medical Intervention/standards , European Union , Female , Humans , Male , Parents/psychology , Personal Satisfaction , Surveys and Questionnaires
10.
Rev. baiana enferm ; 34: e31851, 2020. graf
Article in Spanish | BDENF - Nursing, LILACS | ID: biblio-1115316

ABSTRACT

Objetivo Se presenta una reflexión teórica basada en la experiencia de los autores como investigadores y docentes de unidades curriculares de Metodologías de Investigación. Método reflexión teórica-filosófica. Resultados la dicotomía entre los enfoques cualitativos y cuantitativos dio lugar a la discusión sobre la necesidad de pensar en la posibilidad de combinar estos métodos con el objetivo de responder a los nuevos y complejos problemas de investigación con los que actualmente nos enfrentamos. Esta discusión se transformó en una disputa que algunos autores apodaron "Science War", debido a los desafíos metodológicos y epistemológicos de esta combinación que, por su vez, dio origen a los Métodos Mixtos (Mixed Methods). La reflexión que se propone se centra en algunas de las principales cuestiones que surgen en el ámbito de las actuales discusiones entre investigadores y reflejan/traducen algunas de las inquietudes de los mismos.


Objetivo se presenta una reflexión teórica basada en la experiencia de los autores como investigadores y docentes de unidades curriculares de Metodologías de Investigación. Método reflexión teórica-filosófica. Resultados la dicotomía entre los enfoques cualitativos y cuantitativos dio lugar a la discusión sobre la necesidad de pensar en la posibilidad de combinar estos métodos con el objetivo de responder a los nuevos y complejos problemas de investigación con los que actualmente nos enfrentamos. Esta discusión se transformó en una disputa que algunos autores apodaron "Science War", debido a los desafíos metodológicos y epistemológicos de esta combinación que, por su vez, dio origen a los Métodos Mixtos (Mixed Methods). La reflexión que se propone se centra en algunas de las principales cuestiones que surgen en el ámbito de las actuales discusiones entre investigadores y reflejan/traducen algunas de las inquietudes de los mismos.


Objective this study presents a theoretical reflection based on the experience of the authors as researchers and professors of curricular units of research methodologies. Method theoretical-philosophical reflection. Results the dichotomy between qualitative and quantitative approaches originated the discussion on the need to think about the possibility of combining these methods aiming to answer the new and complex research problems currently facing us. This discussion was transformed into a dispute that some authors nicknamed "Science War", due to the methodological and epistemological challenges of this combination, which, in its turn, originated the Mixed Methods. The proposed reflection focuses on some of the main issues that arise in the scope of the current discussions between researchers and reflecting/translating some of their concerns.


Subject(s)
Humans , Nursing Methodology Research , Qualitative Research , Research Personnel/education , Translating , Evaluation Studies as Topic
11.
Rev Bras Enferm ; 72(4): 1094-1101, 2019 Aug 19.
Article in English, Spanish | MEDLINE | ID: mdl-31432970

ABSTRACT

OBJECTIVE: to explore the deaf people's perceptions about their well-being, published on a weblog. METHOD: A free access spanish blog that's been created and used by deaf people is selected. Under qualitative methodology with a phenomenological approach, through the non-participating and asynchronous observation, sign language speeches are analyzed in 44 video messages uploaded by deaf bloggers. RESULTS: in the speeches analyzed, inclusion's areas cited the most are self-determination, social inclusion and emotional well-being, these latter two in a negative way: social exclusion and emotional distress. FINAL CONSIDERATIONS: The study participants state that the arrangements adopted for their inclusion are not enough, with feelings of discomfort prevailing in all areas and life stages. Solidarity initiatives, elimination of communication barriers and true transforming agents of our society are needed.


Subject(s)
Blogging/standards , Perception , Personal Autonomy , Persons With Hearing Impairments/psychology , Adult , Blogging/trends , Communication Barriers , Female , Humans , Interpersonal Relations , Male , Qualitative Research
12.
Rev. bras. enferm ; 72(4): 1094-1101, Jul.-Aug. 2019. graf
Article in English | BDENF - Nursing, LILACS | ID: biblio-1020535

ABSTRACT

ABSTRACT Objective: to explore the deaf people's perceptions about their well-being, published on a weblog. Method: A free access spanish blog that's been created and used by deaf people is selected. Under qualitative methodology with a phenomenological approach, through the non-participating and asynchronous observation, sign language speeches are analyzed in 44 video messages uploaded by deaf bloggers. Results: in the speeches analyzed, inclusion's areas cited the most are self-determination, social inclusion and emotional well-being, these latter two in a negative way: social exclusion and emotional distress. Final considerations: The study participants state that the arrangements adopted for their inclusion are not enough, with feelings of discomfort prevailing in all areas and life stages. Solidarity initiatives, elimination of communication barriers and true transforming agents of our society are needed.


RESUMO Objetivo: explorar as percepções dos surdos sobre seu bem-estar, publicados num blog. Método: foi selecionado um blog em espanhol de acesso gratuito criado e utilizado por pessoas surdas. Abordagem qualitativa assente na fenomenologia, através da observação assíncrona e não participante, os discursos realizados através de língua gestual são analisados em 44 vídeos que foram enviados por bloggers surdos. Resultados: nos discursos analisados, as áreas de inclusão mais citadas são autodeterminação, inclusão social e bem-estar emocional, sendo estas duas últimas de forma negativa: exclusão social e sofrimento emocional. Considerações finais: Os participantes do estudo afirmam que as alterações adotadas para a sua inclusão não são suficientes, com sentimentos de desconforto permanentes em todas as áreas e fases da vida. Iniciativas de solidariedade, eliminação de barreiras de comunicação e agentes transformadores reais da sociedade são necessários.


RESUMEN Objetivo: explorar las percepciones de bienestar que las personas sordas vierten en un blog de Internet. Método: Se selecciona un blog español de acceso libre creado y utilizado por personas sordas. Bajo una metodología cualitativa con diseño fenomenológico, y a través de la observación no participante y asincrónica, se analizan los discursos en lengua de signos de 44 videomensajes publicados por blogueros sordos. Resultados: las áreas más mencionadas sobre su inclusión en los discursos analizados son la autodeterminación, el bienestar emocional y la inclusión social, estas dos últimas en sentido negativo: malestar emocional y exclusión social. Consideraciones finales: Los participantes del estudio manifiestan que los planes adoptados para su inclusión no son suficientes, y tienen sentimientos de malestar en todas las áreas y etapas vitales. Se hace necesario eliminar las barreras de comunicación y crear iniciativas solidarias con verdaderos agentes transformadores de la sociedad en la que vivimos.


Subject(s)
Humans , Male , Female , Adult , Perception , Persons With Hearing Impairments/psychology , Personal Autonomy , Blogging/standards , Communication Barriers , Qualitative Research , Blogging/trends , Interpersonal Relations
13.
Article in English | MEDLINE | ID: mdl-30261622

ABSTRACT

This study analyzes the views of four groups of healthcare professionals who may play a role in the management of suicidal behavior. The goal was to identify key factors for suicide prevention in different areas of the healthcare system. Qualitative research was conducted using focus groups made up of different healthcare professionals who participated in the identification, management, and prevention of suicidal behavior. Professionals included were primary care physicians, psychologists, psychiatrists, and emergency physicians. 'Suicide' was amongst the most relevant terms that came up in discussions most of the times it appeared associated with words such as 'risk', danger', or 'harm'. In the analysis by categories, the four groups of professionals agreed that interventions in at-risk behaviors are first in importance. Prevention was the second main concern with greater significance among psychiatrists. Primary care professionals call for more time to address patients at risk for suicide and easier access to and communication with the mental health network. Emergency care professionals have a lack of awareness of their role in the detection of risk for suicide in patients who seek attention at emergency care facilities for reasons of general somatic issues. Mental health care professionals are in high demand in cases of self-harm, but they would like to receive specific training in dealing with suicidal behavior.


Subject(s)
Health Personnel/psychology , Suicide Prevention , Humans , Mental Health , Psychiatry , Qualitative Research , Risk-Taking , Spain , Suicidal Ideation
14.
BMC Med ; 16(1): 28, 2018 02 23.
Article in English | MEDLINE | ID: mdl-29471877

ABSTRACT

BACKGROUND: Depression is viewed as a major and increasing public health issue, as it causes high distress in the people experiencing it and considerable financial costs to society. Efforts are being made to reduce this burden by preventing depression. A critical component of this strategy is the ability to assess the individual level and profile of risk for the development of major depression. This paper presents the cost-effectiveness of a personalized intervention based on the risk of developing depression carried out in primary care, compared with usual care. METHODS: Cost-effectiveness analyses are nested within a multicentre, clustered, randomized controlled trial of a personalized intervention to prevent depression. The study was carried out in 70 primary care centres from seven cities in Spain. Two general practitioners (GPs) were randomly sampled from those prepared to participate in each centre (i.e. 140 GPs), and 3326 participants consented and were eligible to participate. The intervention included the GP communicating to the patient his/her individual risk for depression and personal risk factors and the construction by both GPs and patients of a psychosocial programme tailored to prevent depression. In addition, GPs carried out measures to activate and empower the patients, who also received a leaflet about preventing depression. GPs were trained in a 10- to 15-h workshop. Costs were measured from a societal and National Health care perspective. Qualityadjustedlife years were assessed using the EuroQOL five dimensions questionnaire. The time horizon was 18 months. RESULTS: With a willingness-to-pay threshold of €10,000 (£8568) the probability of cost-effectiveness oscillated from 83% (societal perspective) to 89% (health perspective). If the threshold was increased to €30,000 (£25,704), the probability of being considered cost-effective was 94% (societal perspective) and 96%, respectively (health perspective). The sensitivity analysis confirmed these results. CONCLUSIONS: Compared with usual care, an intervention based on personal predictors of risk of depression implemented by GPs is a cost-effective strategy to prevent depression. This type of personalized intervention in primary care should be further developed and evaluated. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01151982. Registered on June 29, 2010.


Subject(s)
Depression/prevention & control , Primary Health Care/economics , Primary Health Care/methods , Cluster Analysis , Cost-Benefit Analysis , Depression/economics , Humans , Quality-Adjusted Life Years , Risk Assessment
15.
Cien Saude Colet ; 21(8): 2365-74, 2016 Aug.
Article in Spanish | MEDLINE | ID: mdl-27557010

ABSTRACT

Quality of life is a concept that reflects the subjective perception of individuals in relation to their degree of satisfaction with their living conditions. It is a concept that involves putting the individual at the forefront, talking about the quality of the professionals involved and influencing the development of programs and the provision of services. The article reflects the opinions that different agents have in relation to disability on given topics related to the model of quality of life such as: the relationship between different agents; the necessary training of professionals in the field of health and/or disability; and the existence of the presence of the participation in society of people with disabilities. Using qualitative methodology, the arguments of the participants in these three issues are discussed. The verbiage, the conceptual map and the analysis of content, performed after the encoding of information, made it possible to detect the perceived needs and satisfaction with the care of the different services. The profile of the qualified professional within the scope of disability is outlined. Proposals for the future are contained in the conclusions, ensuring the improvement of the quality of life of people with disabilities.


Subject(s)
Disabled Persons , Quality of Life , Disabled Persons/psychology , Humans , Qualitative Research
16.
Ciênc. saúde coletiva ; 21(8): 2365-2374, ago. 2016. graf
Article in Spanish | LILACS | ID: lil-792967

ABSTRACT

Resumen La calidad de vida es un concepto que refleja la percepción subjetiva de la persona en relación al grado de satisfacción con sus condiciones de vida. Es un concepto que implica poner en primer plano a la persona, hablar sobre la calidad de los profesionales implicados e influye en el desarrollo de programas y la provisión de los servicios. El artículo refleja la opinión que tienen diferentes agentes relacionados con la discapacidad sobre determinados tópicos vinculados al modelo de calidad de vida como son: relación entre diferentes agentes, la formación necesaria en los profesionales del ámbito de la salud y/o de la discapacidad y el paso de la presencia a la participación en la sociedad de las personas con discapacidad. A través de una metodológica cualitativa, se analizan las argumentaciones de los participantes en estos tres temas. La nube de palabras, el mapa conceptual y el análisis de contenido, realizado tras la codificación de la información, permitieron conocer las necesidades percibidas y la satisfacción con la atención de los diferentes servicios. Se propone el perfil del profesional idóneo en el ámbito de la discapacidad. En las conclusiones obtenidas se recogen propuestas de futuro, facilitadoras de la mejora de la calidad de vida de las personas con discapacidad.


Abstract Quality of life is a concept that reflects the subjective perception of individuals in relation to their degree of satisfaction with their living conditions. It is a concept that involves putting the individual at the forefront, talking about the quality of the professionals involved and influencing the development of programs and the provision of services. The article reflects the opinions that different agents have in relation to disability on given topics related to the model of quality of life such as: the relationship between different agents; the necessary training of professionals in the field of health and/or disability; and the existence of the presence of the participation in society of people with disabilities. Using qualitative methodology, the arguments of the participants in these three issues are discussed. The verbiage, the conceptual map and the analysis of content, performed after the encoding of information, made it possible to detect the perceived needs and satisfaction with the care of the different services. The profile of the qualified professional within the scope of disability is outlined. Proposals for the future are contained in the conclusions, ensuring the improvement of the quality of life of people with disabilities.


Subject(s)
Humans , Quality of Life , Disabled Persons/psychology , Qualitative Research
17.
Ann Intern Med ; 164(10): 656-65, 2016 May 17.
Article in English | MEDLINE | ID: mdl-27019334

ABSTRACT

BACKGROUND: Not enough is known about universal prevention of depression in adults. OBJECTIVE: To evaluate the effectiveness of an intervention to prevent major depression. DESIGN: Multicenter, cluster randomized trial with sites randomly assigned to usual care or an intervention. (ClinicalTrials.gov: NCT01151982). SETTING: 10 primary care centers in each of 7 cities in Spain. PARTICIPANTS: Two primary care physicians (PCPs) and 5236 nondepressed adult patients were randomly sampled from each center; 3326 patients consented and were eligible to participate. INTERVENTION: For each patient, PCPs communicated individual risk for depression and personal predictors of risk and developed a psychosocial program tailored to prevent depression. MEASUREMENTS: New cases of major depression, assessed every 6 months for 18 months. RESULTS: At 18 months, 7.39% of patients in the intervention group (95% CI, 5.85% to 8.95%) developed major depression compared with 9.40% in the control (usual care) group (CI, 7.89% to 10.92%) (absolute difference, -2.01 percentage points [CI, -4.18 to 0.16 percentage points]; P = 0.070). Depression incidence was lower in the intervention centers in 5 cities and similar between intervention and control centers in 2 cities. LIMITATION: Potential self-selection bias due to nonconsenting patients. CONCLUSION: Compared with usual care, an intervention based on personal predictors of risk for depression implemented by PCPs provided a modest but nonsignificant reduction in the incidence of major depression. Additional study of this approach may be warranted. PRIMARY FUNDING SOURCE: Institute of Health Carlos III.


Subject(s)
Depressive Disorder, Major/prevention & control , Primary Health Care/methods , Depressive Disorder, Major/epidemiology , Female , Humans , Incidence , Male , Middle Aged , Risk Assessment/methods , Spain/epidemiology
18.
BMC Fam Pract ; 16: 39, 2015 Mar 20.
Article in English | MEDLINE | ID: mdl-25879932

ABSTRACT

BACKGROUND: In contrast with the recommendations of clinical practice guidelines, the most common treatment for anxiety and depressive disorders in primary care is pharmacological. The aim of this study is to assess the efficacy of a cognitive-behavioural psychological intervention, delivered by primary care psychologists in patients with mixed anxiety-depressive disorder compared to usual care. METHODS/DESIGN: This is an open-label, multicentre, randomized, and controlled study with two parallel groups. A random sample of 246 patients will be recruited with mild-to-moderate mixed anxiety-depressive disorder, from the target population on the lists of 41 primary care doctors. Patients will be randomly assigned to the intervention group, who will receive standardised cognitive-behavioural therapy delivered by psychologists together with usual care, or to a control group, who will receive usual care alone. The cognitive-behavioural therapy intervention is composed of eight individual 60-minute face-to face sessions conducted in eight consecutive weeks. A follow-up session will be conducted over the telephone, for reinforcement or referral as appropriate, 6 months after the intervention, as required. The primary outcome variable will be the change in scores on the Short Form-36 General Health Survey. We will also measure the change in the frequency and intensity of anxiety symptoms (State-Trait Anxiety Inventory) and depression (Beck Depression Inventory) at baseline, and 3, 6 and 12 months later. Additionally, we will collect information on the use of drugs and health care services. DISCUSSION: The aim of this study is to assess the efficacy of a primary care-based cognitive-behavioural psychological intervention in patients with mixed anxiety-depressive disorder. The international scientific evidence has demonstrated the need for psychologists in primary care. However, given the differences between health policies and health services, it is important to test the effect of these psychological interventions in our geographical setting. TRIAL REGISTRATION: NCT01907035 (July 22, 2013).


Subject(s)
Anxiety Disorders/therapy , Cognitive Behavioral Therapy , Depressive Disorder/therapy , Primary Health Care/methods , Adolescent , Adult , Aged , Female , Health Status Indicators , Humans , Male , Middle Aged , Quality of Life , Treatment Outcome , Young Adult
19.
Rev. Esc. Enferm. USP ; 48(spe2): 139-147, 12/2014. graf
Article in English, Spanish | LILACS, BDENF - Nursing | ID: lil-742079

ABSTRACT

According to the WHO (World Health Organization) and the European Union, suicide is considered to be a health problem of prime importance and to be one of the principal causes of unnatural death. In Spain, the number of suicides has increased 12% since 2005 . The Research Project “European Regions Enforcing Actions against Suicide (EUREGENAS), funded by the Health Program 2008-2013, has as main objective the description of an integrated model of Mental Health orientated to the prevention of suicide. The differences that allow distinguishing the meaning of prevention in suicide behavior are described and explained through a qualitative methodological strategy and through the creation of discussion groups formed by different groups of health professionals. The results highlight the existing differences between the diverse health professionals who come more in contact with this problem and it shows as well the coincidence of meaning that suicide has to be considered as a priority in the field of health.


De acordo com a OMS e a União Europeia o suicídio é considerado um problema de primeira ordem e uma das principais causas de morte não natural. Em Espanha, a taxa aumentou 12% desde 2005 (INE, 20014). O projeto de investigação Regiões Europeias Promovendo Acções contra o Suicídio (EUREGENAS), financiado pelo Programa de Saúde 2007-2013, tem como objetivo principal promover um modelo integrado de saúde mental para prevenir o suicídio. Através de uma estratégia metodológica qualitativa e do desenvolvimento de grupos de discusão com diferentes profissionais de saúde, são descritas e interpretadas as diferenças que permitem identificar como discriminar o significado da prevenção de comportamentos suicidas. Os resultados evidenciam as diferenças entre os pontos de vista e práticas dos diferentes profissionais da saúde relacionados com este problema, e a ideia reconhecida em considerar o suicídio como uma prioridade no campo da saúde.


Según la OMS y la Unión Europea, consideran el suicidio un problema de primer orden y una de las principales causas de muerte no natural. En España, la tasa ha aumentado un 12% desde 2005(1). El Proyecto de Investigación Euroepan Regions Enforcing Actions against Suicide (EUREGENAS) financiado por Health Progam 2008-2013, tiene como principal objetivo describir un modelo integrado de Salud Mental orientado a la prevención de suicidio. A través de una estrategia metodológica cualitativa y mediante la elaboración de grupos de discusión con distintos colectivos profesionales de la salud se describen e interpretan las diferencias que permiten discriminar el significado de la prevención de conductas suicidas. Los resultados ponen en evidencia las diferencias existentes entre los diferentes profesionales de la salud más relacionados con este problema y la coincidencia en considerar el suicidio como una prioridad en el ámbito de la salud.


Subject(s)
Suicide/prevention & control , Health Personnel , Spain , Qualitative Research
20.
Univ. psychol ; 13(2): 601-614, abr.-jun. 2014. ilus, tab
Article in Spanish | LILACS | ID: lil-735216

ABSTRACT

El objetivo de este estudio es analizar la intención de uso de la modalidad instructiva blended learning por parte de profesores universitarios, a partir del diseño de un modelo predictivo, tomando como aportes teóricos la Teoría del Comportamiento Planificado (Theory of Planned Behavior), los modelos de aceptación tecnológica (TAM) y la Teoría de la Difusión de Innovaciones (Innovation Diffussion Theory). El modelo teórico planteado está constituido por seis constructos: Utilidad Percibida, Facilidad percibida de Uso, Compatibilidad, Imagen Social, Norma o Influencia Social e Intención de Uso. En el estudio participaron 486 profesores de diferentes universidades españolas. Para el tratamiento de los datos se realizaron Análisis Factorial Confirmatorio (AFC) y análisis causal, conforme al enfoque de ecuaciones estructurales (SEM) con estimación de parámetros, utilizando el método de Máxima Verosimilitud (ML) para el contraste de las relaciones estructurales propuestas. Los resultados revelan que los factores del modelo explican el 41% de la variabilidad de la intención de uso de blended learning en los profesores. Esta intención de adoptar b-learning está positivamente afectada por dos determinantes principales, de un lado, la utilidad percibida sobre la mejora de la práctica docente (valor estandarizado = 0.54, p < 0.001) y la existencia de condiciones favorables (recursos y equipamientos técnicos, humanos, etc.) de la propia universidad para su implementación (β = 0.26, p < 0.001).


The objective of this study is to analyze the intention of the use of the instructional modality blended learning to be used by academics as a predictive model using theoretical contributions from the Theory of Planned Behavior (Theory of Planned Behavior), models of acceptance technology (TAM) and the theory of diffusion of innovation (Innovation diffusion Theory). The theoretical model proposed consists of six constructs: Perceived Usefulness, Perceived Ease of Use, Compatibility Social Image, Social Influence and Intended Use. The study included 486 teachers from different Spanish universities. The data was analyzed using confirmatory factor analysis (CFA). Causal analysis was also utilized, conforming to structural equation approach (SEM), with parameter estimations using the maximum likelihood method (ML) for the contrast of the proposed structural relationships. The results reveal that the model factors explained 41% of the variability of the intended use of blended learning. The intention to adopt b-learning is positively affected by two main determinants, on one side the perceived usefulness of improving teaching practice (standardized value = 0.54, p <0.001) and on the other the existence of favorable conditions (resources and technical equipment, human, etc.) of the university for its implementation (β = 0.26, p < 0.001).


Subject(s)
Faculty , Learning
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