RESUMO
The COVID-19 pandemic is one of the greatest challenges in modern history, with more than four million confirmed deaths worldwide. To date, evidence regarding the psychological impact of the COVID-19 pandemic on grievers is scarce for developing countries such as Mexico. This study aimed to assess the levels of anxiety and associated concerns in a sample of Mexican adults bereaved during the COVID-19 outbreak. A cross-sectional study was conducted through the Duelo COVID (COVID Grief) platform, which is a self-guided online treatment. A total of 5,224 participants reported their anxiety, depression, sleep quality, avoidance, and arousal, prolonged grief symptoms, and medication consumption. Independent sample Mann-Whitney U-tests, chi-square tests, and Kruskal-Wallis tests, as well as multinomial logistic regression, were conducted. Results indicated that 90.4% of the participants reported clinical levels of anxiety, depression, and sleep affectations. The people who lost someone during the last 5 months scored higher in normal grief symptoms compared to the people whose loss was 6 months ago or more, and 9.8% of individuals reported the use of prescription medication, with anxiolytics and antidepressants being the most common. Females, younger respondents, unemployed people with a lower educational level, and participants who disclosed a recent suicide attempt were among those who reported medication consumption. Sleep problems were more frequent in older participants.
RESUMO
Background: COVID-19 has taken many lives worldwide and due to this, millions of persons are in grief. When the grief process lasts longer than 6 months, the person is in risk of developing Complicated Grief Disorder (CGD). The CGD is related to serious health consequences. To reduce the probability of developing CGD a preventive intervention could be applied. In developing countries like Mexico, the psychological services are scarce, self-applied interventions could provide support to solve this problem and reduce the health impact even after the pandemic has already finished. Aims: To design and implement a self-applied intervention composed of 12 modules focused on the decrease of the risk of developing CGD, and increasing the life quality, and as a secondary objective to reduce the symptomatology of anxiety, depression, and increase of sleep quality. The Intervention Duelo COVID (Grief COVID) follows the principles of User Experience (UX) and is designed according to the needs and desires of a sample of the objective participants, to increase the adherence to the self-applied intervention, considered one of the main weaknesses of online interventions. Methods: A Randomized Controlled Trial will be conducted from the 22nd of December of 2020 to the first of June 2021. The participants will be assigned to an intervention with elements of Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Mindfulness and Positive Psychology. The control group will be a wait-list condition, that will receive the intervention 1.5-2 months after the pre-measurement were taken. The Power Size Calculation conducted through G*Power indicated the need for a total of 42 participants, which will be divided by 21 participants in each group. The platform will be delivered through responsive design assuring with this that the intervention will adapt to the screen size of cellphones, tablets, and computers. Ethics and Dissemination: The study counts with the approval of the Research Ethics Committee of the Autonomous University of Ciudad Juárez, México, and it is registered in Clinical Trials (NCT04638842). The article is sent and registered in clinical trials before the recruitment started. The results will be reported in future conferences, scientific publications, and media.
RESUMO
Resumen El alivio del sufrimiento existencial en los pacientes oncológicos en estadio avanzado es un objetivo terapéutico de primer orden. En el presente trabajo se sugieren una serie de ejes sobre los cuales podría pivotar la intervención psicoterapéutica, con el fin de propiciar: 1) la experiencia de que a pesar del "ya" de la situación límite, la vida "todavía" tiene sentido; 2) experiencias emocionales positivas que promuevan el bienestar y la calidad de vida; 3) el afrontamiento de la experiencia de enfermedad grave y de muerte esperada más o menos inminente, mediante el desarrollo de una actitud serena, reconciliada con la vida e integradora con uno mismo y con los demás, a la par que abierta a la trascendencia.
Abstract The relief of existential suffering in the patients with adavanced cancer is a first-order therapeutic goal. The present work suggests some axis on which psychotherapeutic intervention could be developed, in order to facilitate in these patients: 1) The experience of: In spite of the "existing" limited situation, one's life "still" has meaning, 2) Positive emotional experiences that promote well-being and quality of life, and 3) Face the serious illness that will cause one's almost imminent death, through the development of a serene, reconciled attitude with life and integrating with oneself and the others.
Resumo O alívio do sofrimento existencial em pacientes oncológicos em estágio avançado é um objetivo terapêutico de primeira ordem. No presente trabalho, sugerimos uma série de eixos nos quais a intervenção psicoterapêutica poderia girar, a fim de promover: 1) a experiência de que, apesar do "já" da situação limite, a vida "ainda" faz sentido; 2) experiências emocionais positivas, que promovam bem-estar e qualidade de vida; 3) enfrentar a experiência de doença grave e morte esperada mais ou menos iminente, através do desenvolvimento de uma atitude serena, conciliada com a vida e integrando-se consigo mesmo e com os outros, ao mesmo tempo que aberta à transcendência.