RESUMEN
Background: The adverse consequences of the COVID-19 pandemic on mental health have been widely studied in recent months. However, few studies have examined the protective psychological factors that may explain how individuals are coping with the COVID-19 pandemic and its forced confinements. Objective: This study analyzes the impact of confinement due to the COVID-19 pandemic on positive functioning variables (resilience, meaning of life, gratitude, compassion, life satisfaction), emotional distress (depression, anxiety, perceived stress, affect), and posttraumatic growth (PTG). The impact was measured during and after the first month of strict and obligatory confinement in Spain. Methods: The sample was composed of 438 Spanish residents (78.3% women) between the ages of 18 and 68 (M = 35.68; SD = 13.19) during the first stage (first two weeks) of confinement. The sample was reduced to 197 participants during the second stage (fifth week) of confinement. Several online self-reported questionnaires were administered to assess positive functioning variables, emotional distress, and PTG. Results: Women, youths, individuals without a partner, with lower monetary incomes, or diagnosed with a mental disorder or chronic illness experienced lower scores in positive functioning variables and greater emotional distress during the first stage of confinement. Linear mixed models showed that scores on positive functioning variables, emotional distress, and PTG worsened in the second stage of confinement. Nevertheless, a structural equations model showed that increases in positive functioning variables in the second stage were associated with increases in life satisfaction (R2 = .450) and related to decreases in emotional distress (R2 = .186), leading in turn to increases in PTG (R2 = .061). Conclusions: Individuals could experience PTG during strict and mandatory confinement. The increase in PTG during this adverse event was indirectly associated with increases in positive functioning variables (i.e. gratitude, presence of meaning, resilience), through improvements in life satisfaction and emotional distress.
Antecedentes: Las consecuencias adversas de la pandemia de COVID-19 en la salud mental han sido ampliamente estudiadas en los últimos meses. Sin embargo, pocos estudios han examinado los factores psicológicos protectores que pueden explicar cómo los individuos están haciendo frente a la pandemia de COVID-19 y sus confinamientos forzados.Objetivos: Este estudio analiza el impacto del confinamiento debido a la pandemia COVID-19 sobre las variables de funcionamiento positivo (resiliencia, sentido en la vida, gratitud, compasión, satisfacción con la vida), el malestar emocional (depresión, ansiedad, estrés percibido, afecto) y el crecimiento postraumático (CPT). El impacto se midió durante y después del primer mes de un confinamiento estricto y obligatorio en España.Métodos: La muestra estuvo compuesta por 438 residentes españoles (78.3% mujeres), con edades comprendidas entre 18 y 68 años (M= 35.68; DT= 13.19) en la primera medición (las dos primeras semanas de confinamiento). La muestra se redujo a 197 participantes en la segunda medición (la quinta semana de confinamiento). Se administraron varios cuestionarios auto-informados online dirigidos a evaluar las variables de funcionamiento positivo, el malestar emocional y el CPT.Resultados: Los participantes que eran mujeres, más jóvenes, sin pareja, con ingresos económicos más bajos, o diagnosticados con un trastorno mental o enfermedad crónica, experimentaron menores puntuaciones en variables de funcionamiento positivo y mayor malestar emocional en las primeras semanas del confinamiento. Los modelos lineales mixtos mostraron que las puntuaciones en las variables de funcionamiento positivo, el malestar emocional y el CPT empeoraron en la segunda etapa del confinamiento. Sin embargo, un modelo de ecuaciones estructural mostró que los aumentos en la segunda etapa en las variables positivas de funcionamiento se asociaban con aumentos en la satisfacción de la vida (R2 = .450), y se relacionaban con disminuciones en el malestar (R2 = .186), lo que a su vez conducía a aumentos en el CPT (R2 = .061).Conclusiones: Las personas pueden experimentar CPT durante el confinamiento estricto y obligatorio. El aumento de la CPT durante dicho evento adverso se asoció indirectamente con el aumento de las variables de funcionamiento positivo (i.e. gratitud, sentido en la vida, resiliencia), a través de las mejoras en la satisfacción de la vida y el malestar emocional.
RESUMEN
BACKGROUND: Depression is one of the world's major health problems. Due to its high prevalence, it constitutes the first cause of disability among the Americas, where only a very low percentage of the population receives the adequate evidence-based psychological treatment. Internet-Based Interventions (IBIs) are a great alternative to reduce the treatment gap for mental disorders. Although there are several studies in low-and middle-income countries proving IBIs' feasibility and acceptability, there is still little evidence of the effectiveness in diverse social and cultural contexts such as Latin America. METHODS: Two studies will be described: Study 1 is focused on the cultural adaptation of a cognitive-behavioral IBI Smiling is Fun (Botella et al. 2012, 2015) for Ecuadorian population with depression based on the procedure by Salamanca-Sanabria et al. (2018). Study 2 describes the design of a randomized controlled trial to test the preliminary efficacy of the culturally adapted intervention in a Public Health Care setting. A total of 153 patients with mild to moderate degree of depression as assessed with the Mini-International Neuropsychiatric Interview (M.I.N.I.) and the Patient Health Questionnaire-9 (PHQ-9) will be randomly assigned to either an IBI group using only automated support by the system; an IBI group including also minimal human support; or a waiting list group. The primary outcome (depression) and secondary outcomes (e.g., anxiety, affect, quality of life) will be collected at baseline, 3, 6 and 12 months. Mixed-model analyses with no ad hoc imputations will be conducted. DISCUSSION: This paper is pioneering in exploring the role of an Internet-based culturally adapted intervention for depression in a public care context in Ecuador. Results obtained will offer new insights into the viability and effectiveness of digital technologies for the psychological treatment of mental illnesses in developing countries.
RESUMEN
Background: Infertility is estimated to affect 15% of couples of reproductive age. Weight management problems (being obese or overweight) are among the problems that produce infertility, both in women seeking spontaneous pregnancy and in those undergoing assisted reproduction techniques. Over the last few decades, the prevalence of obesity has increased alarmingly in our society and is now considered one of the most important public health problems. The combination of diet and exercise to achieve weight loss are currently considered an effective intervention for the improvement of reproductive parameters in overweight or obese infertile women. In other population groups, it has been shown that Internet-based interventions are just as effective as traditional ones, and these cover a larger population with a good cost-benefit ratio. However, to the best of our knowledge, no studies so far have analysed any specific online interventions for this group of infertile women. Thus, the objective of this project will be to evaluate the effectiveness of an online program to promote a healthy lifestyle among women who are overweight or obese who also have a diagnosis of infertility and are on the waiting list for in vitro fertilisation treatment. Methods: This will be a randomised controlled clinical trial conducted in 94 women which will compare a self-administered Internet-based intervention promoting a healthy lifestyle in terms of diet and exercise (n = 47) to a control group that will receive standard medical care. The online program will comprise nine modules, will last for 3 months, and will be monitored every 3 months after the intervention until the final follow-up at 12 months. The main outcome will be the spontaneous pregnancy rate. Secondary outcomes will include changes in body composition, dietary and physical exercise habits, glycaemic profiles, lipid profiles, hormonal profiles, and patient quality of life related to their fertility problems. The data analysis will be done on an intention-to-treat basis. Discussion: The aim of this study is to increase our knowledge of the effectiveness of online interventions specifically adapted to infertile women who are overweight or obese in the promotion of healthy lifestyles.