Intervención digital basada en la atención plena para estrés y ansiedad generalizada en trabajadores universitarios / Digital intervention based on mindfulness for stress and generalized anxiety in university workers

Resumen Objetivo: Analizar el efecto y la percepción de una intervención digital, basada en atención plena para disminuir el estrés y ansiedad generalizada entre los trabajadores de la Universidad Veracruzana (UV). Materiales y Métodos: Un ensayo clínico aleatorizado se llevó a cabo con 102 participantes, divididos en un grupo experimental y un grupo control para evaluar el efecto de una intervención a través de WhatsApp, en la reducción del estrés y la ansiedad. El grupo experimental recibió un programa de meditación con el fin de capacitarlos y enseñarles a practicar la atención plena. Se utilizaron las escalas de estrés percibido PSS-10 y del trastorno de la ansiedad generalizada GAD-7 para evaluar el efecto de la intervención. Los participantes expresaron su opinión sobre la intervención mediante entrevistas focalizadas con preguntas estandarizadas. Resultados: Se encuentra una disminución en las medianas del nivel de estrés percibido y ansiedad generalizada del grupo experimental entre el momento pre-intervención y post-intervención, con una diferencia estadísticamente significativa, p=0.012 y p=0.013, respectivamente. En el grupo control se visualiza un ligero aumento en dichos niveles y no se identifican diferencias significativas entre la medición basal y final, tanto en estrés como en ansiedad. En el análisis del espectro del discurso, se examinó la categoría de "Usabilidad" y se identificaron diferentes aspectos relacionados con la percepción, participación y recomendación de la intervención. Conclusiones: Se encontró una mejoría estadísticamente significativa en los niveles de estrés y ansiedad generalizada. Se demuestra que, realizar intervenciones en salud pública que involucren la tecnología, es cada vez más adaptable y contribuye al avance del conocimiento dentro del autocuidado de la salud mental entre los trabajadores de la Universidad Veracruzana.

Abstract Objective: To analyze the effect and perception of a digital intervention, based on mindfulness to reduce stress and generalized anxiety among workers at the Universidad Veracruzana (UV). Materials and Methods: A randomized clinical trial was carried out with 102 participants, divided into an experimental group and a control group to evaluate the effect of an intervention through WhatsApp in reducing stress and anxiety. The experimental group received a meditation program in order to train and teach them to practice mindfulness. The PSS-10 Perceived Stress and GAD-7 Generalized Anxiety Disorder scales were used to assess the effect of the intervention. Participants expressed their opinion about the intervention through focused interviews with standardized questions. Results: There is a decrease in the median level of perceived stress and generalized anxiety of the experimental group between the pre-intervention and post-intervention moments, with a statistically significant difference, p=0.012 and p=0.013, respectively. In the control group, a slight increase in said levels was observed and no significant differences were identified between the baseline and final measurement, both in stress and anxiety. In the discourse spectrum analysis, the "Usability" category was examined and different aspects related to the perception, participation and recommendation of the intervention were identified. Conclusions: A statistically significant improvement was found in the levels of stress and generalized anxiety. It is shown that carrying out public health interventions that involve technology is increasingly adaptable and contributes to the advancement of knowledge within mental health self-care among workers at the Universidad Veracruzana.

Age Under 30 Years As a Predictor of Poor Survival in a Cohort of Mexican Women With Breast Cancer.

INTRODUCTION: Young women under 30 years with breast cancer (BC) are an emerging challenge. The purpose is to identify prognostic factors for survival in young women under 30 years of age with BC. MATERIAL AND METHODS: A retrospective cohort study was conducted among women younger than or equal to 40 years with BC and who were treated at the State Cancer Center during the period 2012-2017. Overall survival was assessed using the Kaplan-Meier method and the log-rank test. Univariate and multivariate analysis assessed survival predictors using Cox proportional hazards regression model. RESULTS: 282 young women were included. The >30-year-old subgroup showed a significant association with excess weight (P = .002) compared to the <30-year-old group. The <30-year-old subgroup showed a poor overall survival (56.7%), as well as highly significant values in advanced clinical stages, metastatic nodules, metastasis, and neoadjuvant therapy (P < .001). In Model 3 of the multivariate analysis, age <30 years (HR = 3.0; 95% CI 1.1 to 8.6), triple negative subtype (HR = 2.6; 95% CI 1.1 to 6.0), tumor size >5 cm HR = 2.3; 95% CI 1.03 to 5.1), and advanced clinical stages (HR = 6.6 95% CI 1.3 to 35.5) persisted as predictors. CONCLUSIONS: Being very young (<30 years) is a predictor for limited survival compared to the age of 30-40 years, as well as the tumor covariates for a worse prognosis: triple negative subtype, advanced stages, positive lymph nodes, and distant metastases in liver.

Characteristics of healthy behavior in Mexican women who survived breast cancer.

OBJECTIVE: This paper aims to assess diet and lifestyle by designing a healthy behavior index (HBI) related to the educational level and time of breast cancer (BC) diagnosis. METHODS: 241 female breast cancer survivors treated at Centro Estatal de Cancerología (State Cancer Center) in Mexico were assessed based on dietary pattern, physical activity, smoking, alcohol consumption, body size and shape, sleep disorders with increasing scores that represent less healthy characteristics. The odds ratios (OR) and quartiles of the healthy behavior index and the time of diagnosis were estimated. The regression model was used to assess the association between HBI and the BC covariates. RESULTS: The healthy behavior index for the two first quartiles was that of p < 0.001. The graphic behavior of correspondence with the covariates (age, schooling and moderate physical activity) showed a different three-dimensional effect on healthy behaviors. According to diagnosis time ≤ three years, the following covariates were significant: socioeconomic status, (OR: 4.34 CI 95% 1.2-9.5), sleep disturbances (p = 020) and protective intake of fruits and vegetables (p = 0.001). In the multivariate analysis, survivors with a high level of education are significantly more likely to show a healthy behavior (OR: 0.3 95% CI 0.12 - 0.8); as well as the early clinical stages (OR: 0.4 95% CI 0.2-0.9). CONCLUSION: In breast cancer survivors, both the high level of education and early clinical stages were important healthy behavior modifiers. PRACTICE IMPLICATIONS: Since diets are potentially modifiable, the findings may have further implications to promote a careful dietary pattern to prevent breast cancer. These variables should be assessed as a strategy in cancer survivor preventive programs.