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Purpose: This study aimed to assess the level of anxiety and depression in relatives of critically ill COVID-19 patients admitted to the intensive care unit (ICU), and to perform an exploratory pilot study on the implementation of telephone psychological interventions to reduce the initial levels of anxiety and depression in this population. Patients and Methods: Family members of COVID-19 inpatients at ICU answered GAD-7, PHQ-9 and questions on socio-demographic data. A brief psychological intervention was applied via telephone based on the needs of the participants (with adequate adaptation, with symptoms of anxiety, depression, or both). After intervention, participants completed the Patient Global Impression of Change Scale. Results: A total of 1307 relatives were included (66.5% female), 34% and 29% had anxiety and depressive symptoms, respectively. These symptoms were associated with female gender, unemployment, and being the parent or partner of the patient. After intervention, 57.9% reported felt better, 31.3% a little better and 6.6% much better; and with emotional regulation techniques and psychoeducation, higher percentages of feeling better or much better were reported. Conclusion: Brief interventions to reduce the psychological impact of inpatient family members could be effective but will need to be explored further in future studies.
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BACKGROUND: The mental health and medical follow-up of people living with HIV (PLWH) have been disrupted by the COVID-19 pandemic. The objectives of this study were to assess anxiety, depression and substance use in Mexican PLWH during the pandemic; to explore the association of these symptoms with adherence to antiretroviral therapy (ART), and to compare patients with and without vulnerability factors (low socioeconomic level, previous psychological and/or psychiatric treatment). METHODS: We studied 1259 participants in a cross-sectional study, PLWH receiving care at the HIV clinic in Mexico City were contacted by telephone and invited to participate in the study. We included PLWH were receiving ART; answered a structured interview on sociodemographic data and adherence to ART; and completed the psychological instruments to assess depressive and anxiety symptoms and substance use risk. Data collection was performed from June 2020 to October 2021. RESULTS: 84.7% were men, 8% had inadequate ART adherence, 11% had moderate-severe symptoms of depression, and 13% had moderate-severe symptoms of anxiety. Adherence was related to psychological symptoms (p < 0.001). Vulnerable patients were more likely to be women, with low educational level and unemployed (p < 0.001). CONCLUSIONS: It is important to address mental health of PLWH during the COVID-19 pandemic, with special attention to the most vulnerable individuals. Future studies are needed to understand the relationship between mental health and ART adherence.
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COVID-19 , Infecções por HIV , Transtornos Relacionados ao Uso de Substâncias , Masculino , Humanos , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Pandemias , Saúde Mental , Estudos Transversais , México/epidemiologia , Adesão à Medicação , COVID-19/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/epidemiologiaRESUMO
Abstract Introduction Cognitive assessment is the process whereby individuals assess the effect an adverse circumstance has on their well-being (primary assessment) and their ability to cope with it (secondary assessment), which is closely related to the emotional and behavioral response they show as a result. Objective To determine the validity and internal consistency of the Spanish version of the Cognitive Assessment Inventory (CAI) for patients with chronic pain for Mexican population. Method A total of 191 adults with chronic pain completed the Spanish version of the CAI, as well as self-report measures of disability, daily activities, anxiety, and depression. Results The confirmatory factor analysis for each type of primary cognitive assessment included in the CAI yielded models with satisfactory goodness of fit and Cronbach's α indices (loss/damage: CMIN/DF = 1.132, NFI = .935, CFI = .992, AGFI = .939, SRMR = .046, RMSEA = .026, α = .73; threat: CMIN/DF = 1.132, NFI = .935, CFI = .992, AGFI = .939, SRMR = .046, RMSEA = .026, α = .81; and challenge: CMIN/DF = 1.567, NFI = .939, CFI = .977, AGFI = .926, SRMR = .044, RMSEA = .055, α = .86). Cognitive assessments of loss/harm and threat were positively associated with the degree of disability, depression, and anxiety, and negatively associated with the performance of daily activities. The opposite occurred with the cognitive assessment of challenge. Discussion and conclusion The Spanish version of the CAI is a valid, quick, easy, and reliable tool for evaluating the primary cognitive assessment of pain, a construct closely related to physical disability and emotional suffering in response to this experience, which may be modified through brief cognitive interventions.
Resumen Introducción La evaluación cognoscitiva es el proceso mediante el cual un individuo valora el efecto que ejerce una circunstancia adversa en su bienestar (evaluación primaria) junto con las capacidades con que cuenta para afrontarla (evaluación secundaria), con ello guarda una estrecha relación con la respuesta emocional y conductual que despliega en consecuencia. Objetivo Determinar la validez y consistencia interna de la versión en español del Inventario de Evaluación Cognoscitiva (IEC) para pacientes con dolor crónico en población mexicana. Método Un total de 191 adultos con dolor crónico completaron la versión en español del IEC, así como medidas de autorreporte de discapacidad, actividades cotidianas, ansiedad y depresión. Resultados El análisis factorial confirmatorio para cada tipo de evaluación cognoscitiva primaria incluida en el IEC arrojó modelos con índices de bondad de ajuste y α de Cronbach satisfactorios (pérdida/daño: CMIN/DF = 1.132, NFI = .935, CFI = .992, AGFI = .939, SRMR = .046, RMSEA = .026, α = .73; amenaza: CMIN/DF = 1.132, NFI = .935, CFI = .992, AGFI = .939, SRMR = .046, RMSEA = .026, α = .81; y desafío: CMIN/DF = 1.567, NFI = .939, CFI = .977, AGFI = .926, SRMR = .044, RMSEA = .055, α = .86). Las evaluaciones cognoscitivas de pérdida/daño y de amenaza se asociaron positivamente con el grado de discapacidad, depresión y ansiedad, y de forma negativa con la ejecución de actividades cotidianas. Lo contrario ocurrió con la evaluación cognoscitiva de desafío. Discusión y conclusión La versión en español de la IEC es una herramienta fácil, rápida, válida y confiable para evaluar la evaluación cognoscitiva primaria del dolor, constructo íntimamente relacionado con la discapacidad física y el sufrimiento emocional ante esta experiencia susceptible de modificación mediante intervenciones cognoscitivas breves.
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Our aim was to assess the severity of anxiety in PLWHA in Mexico City and obtain the psychometric properties of the culturally-adapted Spanish version of GAD-7. Thirteen percent of participants presented moderate to severe symptoms. Reliability (α = 0.82) and construct validity (single-factor explained 48.9% of variance) were evaluated in 411 participants. Confirmatory Factor Analysis was performed in a second sample of 527 participants. Model fit adequately (CFI = 0.991; CMIN/DF = 1.924; RMSEA = 0.042; and SRMR = 0.026). The adapted version of GAD-7 was adequate for the assessment of anxiety in Mexican PLWHA.
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Infecções por HIV , Questionário de Saúde do Paciente , Ansiedade/diagnóstico , Infecções por HIV/diagnóstico , Humanos , México , Psicometria , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
There are two main problems reported in the intervention programs addressing teenage substance users: 1) limited admission to treatment, 2) high drop out rates. Institutions in other countries working with teenage substance users report a dropout rate between 50 and 70% after the first session at early treatment stages. In Mexico, a study on dropout rates in a brief intervention program found rates of 53%, with teenagers dropping out between the first and second session. In the addictive behavior field, there is a factor involved in the lack of acceptance for treatment and the dropout rate during treatment. This factor is the perception of addiction treatment programs and teenagers' readiness for change their consumption. Particularly, it was proposed that the lack of agreement over the actions that the therapist and the user develop, jointly and individually, affects the admission to and permanence of users in treatment programs. In addition, Yahne & Miller consider that most of the people can be admitted to the program without any willingness or with a limited willingness to change their consumption. This suggests the need for strategies that increase teenagers' interest in modifying their substance consumption. That is why this study reports the results of an evaluation of an induction to treatment session as a part of the <
Entre los programas de intervención dirigidos a los adolescentes que abusan del alcohol y otras drogas se han reportado dos grandes problemas: 1. la escasa aceptación para ingresar a tratamiento y 2. las altas tasas de abandono. Instituciones de otros países que trabajan con adolescentes usuarios de sustancias, reportan una tasa de deserción después de un primer contacto de entre el 50% y el 70% en fases tempranas del tratamiento. En México, un estudio sobre la deserción de los adolescentes participantes en un programa de intervención breve determinó que el porcentaje de deserción fue del 53% y la deserción se presentó entre la primera y la segunda visita al terapeuta. Algunos de los factores implicados en la falta de aceptación del tratamiento y la deserción durante el tratamiento en el campo de las adicciones, son la etapa de disposición a cambiar su consumo en la que se encuentran los sujetos y su percepción acerca de los tratamientos de las adicciones. En este sentido, en este trabajo se reporta la evaluación de una sesión de inducción al tratamiento como parte del <