El Cuestionario de Salud SF-36 español: una década de experiencia y nuevos desarrollos

Effects of a back school-based intervention on non-specific low back pain in adults: a randomized controlled trial

BACKGROUND

Non-specific low back pain is a common condition with significant global prevalence and socio-economic impact. Back School programs, which combine exercise and educational interventions, have been used to address back pain. This study aimed to investigate the effects of a Back School-based intervention on non-specific low back pain in adults. Secondary objectives included evaluating the impact of the program on disability, quality of life, and kinesiophobia.

METHODS

A randomized controlled trial was conducted involving 40 participants with non-specific low back pain, who were divided into two groups. The experimental group underwent an 8-week Back School-based program. The program comprised 14 practical sessions focusing on strengthening and flexibility exercises, along with two theoretical sessions covering anatomy and concepts related to a healthy lifestyle. The control group maintained their usual lifestyle. Assessment instruments included the Visual Analogue Scale, Roland Morris disability questionnaire, Short-Form Health Survey-36, and Tampa Scale of Kinesiophobia.

RESULTS

The experimental group showed significant improvements in the Visual Analogue Scale, Roland Morris disability questionnaire, physical components of the Short-Form Health Survey-36, and Tampa Scale of Kinesiophobia. However, there were no significant improvements in the psychosocial components of the Short-Form Health Survey-36. In contrast, the control group did not show significant results in any of the study variables.

CONCLUSIONS

The Back School-based program has positive effects on pain, low back disability, physical components of quality of life, and kinesiophobia in adults with non-specific low back pain. However, it does not appear to improve the participants' psychosocial components of quality of life. Healthcare professionals can consider implementing this program to help reduce the significant socio-economic impact of non-specific low back pain worldwide.

TRIAL REGISTRATION

NCT05391165 (registered prospectively in ClinicalTrials.gov: 25/05/2022).

Health-related quality of life and mortality in the 'Seguimiento Universidad de Navarra' prospective cohort study

OBJECTIVE

To study the association between health-related quality of life (HRQoL) and all-cause mortality in a healthy middle-aged Mediterranean cohort.

METHODS

We included 15,390 participants -mean age 42.8 years at first HRQoL ascertainment, all university graduates-. HRQoL was assessed with the self-administered Medical Outcomes Study Short Form-36 (SF-36) twice, with a 4-year gap. We used multivariable-adjusted Cox regression models to address the relation between self-reported health and Physical or Mental Component Summary (PCS-36 or MCS-36) and mortality, and their interaction with prior comorbidities or adherence to the Mediterranean diet (MedDiet).

RESULTS

Over 8.7 years of median follow-up time, 266 deaths were identified. Hazard ratio (HR) for the excellent vs. poor/fair category in self-reported health was 0.30 (95 % confidence interval (CI), 0.16-0.57) in the model with repeated measurements of HRQoL. Both the PCS-36 (HRquartile4(Q4)vs.Q1 0.57 [95%CI, 0.36-0.90], ptrend < 0.001; HRper+10points: 0.64 [95%CI, 0.54-0.75]) and the MCS-36 (HRQ4vs.Q1 0.67 [95%CI, 0.46-0.97], ptrend = 0.025; HRper+10points: 0.86 [95%CI, 0.74-0.99]) were inversely associated with mortality in the model with repeated measurements of HRQoL. Previous comorbidities or adherence to the MedDiet did not modify these associations.

CONCLUSIONS

Self-reported HRQoL -assessed as self-reported health, PCS-36 and MCS-36- obtained with the Spanish version of the SF-36 were inversely associated with mortality risk, regardless of the presence of previous comorbidities or adherence to the MedDiet.

Spanish Version of the Anterior Cruciate Ligament-Quality of Life Questionnaire: Translation, Cross-cultural Adaptation, and Validation

Background

The Anterior Cruciate Ligament-Quality of Life (ACL-QOL) questionnaire is a patient-reported outcome measure used to assess the effect of an anterior cruciate ligament (ACL) injury on the lives of patients. It was originally written in English, which may affect its use when completed by nonnative English speakers.

Purpose

To translate and adapt the ACL-QOL to Spanish and provide evidence of its psychometric properties.

Study Design

Cohort study (diagnosis); Level of evidence, 2.

Methods

A total of 183 patients with an ACL injury from 4 Catalan hospitals were included: 99 patients who had undergone ACL reconstruction (ACLR) completed the Spanish version of the ACL-QOL (ACL-QOL-Sp) twice (mean interval, 15.2 days) in 2 weeks for test-retest reliability, and 84 patients completed the ACL-QOL-Sp, the Lysholm knee scoring scale, the Knee injury and Osteoarthritis Outcome Score (KOOS), Tegner Activity Scale, and the 12-item Short Form Health Survey (SF-12) before and at 4 and 9 months after ACLR to assess responsiveness. The association between the ACL-QOL-Sp and the other outcome measures was evaluated with the Spearman correlation coefficient.

Results

The ACL-QOL-Sp showed good internal consistency (Cronbach alpha = 0.96) and test-retest reliability (intraclass correlation coefficient = 0.97). The standard error of measurement was 3.6, also suggesting the precision of measurements. The smallest detectable change was 9.98 in 94% of patients. No association was found between the ACL-QOL-Sp score and the Tegner score or SF-12 mental component summary score; however, a moderate correlation was found with the overall KOOS score (r = -0.545), Lysholm score (r = 0.509), and SF-12 physical component summary score (r = 0.607). The correlation ranged from weak for the KOOS-Symptoms subscore (r = -0.290) to moderate for the KOOS-Quality of Life subscore (r = -0.698). No ceiling or floor effects were observed. The ACL-QOL-Sp showed a moderate effect size (0.73) at 4 months but a large effect size (1.70) at 9 months.

Conclusion

The ACL-QOL-Sp showed adequate internal consistency, test-retest reliability, and responsiveness in evaluating quality of life after ACLR in Spanish-speaking patients.

Health-Related Quality of Life in Pregnant Women during the First Trimester in Northern Spain: A Descriptive Cross-Sectional Study

BACKGROUND

Achieving the optimal quality of life is currently a health challenge for the world's population. Pregnancy is a stressful period of life that affects women's quality of life.

AIMS

This study aimed to describe and analyse the health-related quality of life in pregnant women during their first trimester in a health area in the north of Spain.

METHODS

A cross-sectional descriptive study was carried out. A total of 359 women completed the 36-Item Short-Form Health Survey.

RESULTS

The sample consisted of 57.9% primiparous women, 30% had experienced a previous abortion, and 7.2% were foreign women. The mean age was 33.53 years. The sum of the physical and mental component values was below 50 points. Notably, 4.17% of women reported a worsening of their health in the last year, and 28.69% had an increased depression risk.

CONCLUSION

Being a foreigner, prenatal abortion, previous caesarean section, previous children, or assisted reproduction techniques are the variables that have a negative association with some dimensions of quality of life in pregnant women.

Effectiveness of a Manual Therapy Protocol in Women with Pelvic Pain Due to Endometriosis: A Randomized Clinical Trial

A randomized controlled trial was carried out to assess the effectiveness of a manual therapy protocol in terms of the clinical characteristics, quality of life, and emotional condition of the women with endometriosis-related pelvic pain. Forty-one women (mean age of 36.10 (6.97) years) with pelvic pain due to endometriosis were randomly divided into (i) a manual therapy group (MTG) (n = 21) and (ii) a placebo group (PG) (n = 20). Both groups received an 8-week intervention. Pain, lumbar mobility, endometriosis health profile, quality of life, depression and anxiety levels, and the patient's perception of change were assessed before (T0) and after (T1) the intervention, as well as at a one-month follow-up (T2) and a six-month follow-up (T3). The MTG significantly improved pain intensity, powerlessness, lumbar mobility, and physical quality of life at T1 (p < 0.05). The results were maintained for pain intensity at T2 and T3. In addition, both the MTG and PG improved emotional wellbeing at T1 (p < 0.05). Neither group improved in terms of social support, self-image, and depression and anxiety levels after the intervention (p > 0.05). In conclusion, manual therapy may be an excellent complement to the gynecological treatment of endometriosis-related pelvic pain by alleviating pain and improving women's endometriosis health profile and physical quality of life.

Personality Traits and Coping Strategies as Psychological Factors Associated with Health-Related Quality of Life in Highly Sensitive Persons

Sensory-Processing Sensitivity (SPS) is the reactivity to different stimuli that occurs in some people with sufficient intensity to cause interference in daily life. There are not many previous studies that determine the influence of adaptive and maladaptive coping strategies on health-related quality of life through indicators of mental (anxiety and depression) and physical (vitality) health and functioning in their lives in different contexts (emotional role functioning). In this sense, contexts that promote the use of successful stress-coping strategies are related to the presence of positive mental health outcomes. This study focuses on the analysis of indicators of health-related quality of life in people with SPS in relation to certain personality traits and coping strategies. Participants (N = 10,525) completed HSPS-S, NEO-FFI, CSI, and SF-36. Differences were observed between men and women. Differences indicated that women had higher SPS scores compared to men and poorer health-related quality of life. The results showed significant relationships with the three indicators of health-related quality of life. Finally, it is confirmed that neuroticism and the use of maladaptive coping strategies act as risk factors, whereas extraversion, conscientiousness, and adaptive coping strategies act as protective factors. These findings highlight the need to develop prevention programs for highly sensitive persons.

Does Quality of Life in Survivors of Surgery for Acute Left-Sided Infective Endocarditis Differ from Non-Endocarditis Patients?

Surgery for left-sided infective endocarditis (IE) has been demonstrated to improve patients' survival rates but information about quality of life (QoL) after surgery is scarce. The aim of this study was to assess the postoperative outcomes and QoL after surgery for IE patients compared to patients undergoing cardiac surgery for non-IE indications. Adult patients with definite acute left-sided IE were matched 1:1 to patients who underwent cardiac surgery for non-endocarditic purposes from 2014 to 2019. QoL was assessed using the SF-36 survey at the last follow-up. A total of 105 patients were matched. The IE group had higher rates of preoperative stroke (21% vs. 7.6%, p = 0.005) and higher stages of NYHA class (p < 0.001), EuroSCORE II (12.3 vs. 3.0, p < 0.001) and blood cell count abnormalities (p < 0.001). The IE group had higher incidence of low cardiac output syndrome (13.3% vs. 4.8%, p = 0.029), dialysis (10.5% vs 1.0%, p = 0.007) and prolonged mechanical ventilation (16.2% vs. 2.9%, p = 0.002) after surgery. At the last follow-up, subcomponents of the SF-36 QoL survey were not different between the groups. Patients who underwent cardiac surgery for IE demonstrated a higher risk profile with a higher rate of postoperative complications. Once recovered from the acute phase of the disease, the reported QoL at follow-up was comparable to that of matched cardiac patients operated for non-IE purposes.

Effects of back school-based intervention on non-specific neck pain in adults: a randomized controlled trial

BACKGROUND

Neck pain has a high prevalence and socioeconomic impact worldwide. The Back School consists of programs that include exercises and educational interventions to treat back pain. Accordingly, the main objective was to evaluate the effects of an intervention based on Back School on non-specific neck pain in an adult population. The secondary objectives were to analyze the effects on disability, quality of life and kinesiophobia.

METHODS

A randomized controlled trial was conducted with 58 participants with non-specific neck pain divided into two groups. The experimental group (EG) carried out the 8-week programme based on the Back School, (two sessions per week, for a total of 16 sessions, lasting 45 min). Of all the classes, 14 had a practical focus (strengthening and flexibility exercises) and the other two had a theoretical focus (concepts of anatomy and healthy lifestyle). The control group (CG) stated that they did not vary their lifestyle. The assessment instruments were: Visual Analogue Scale, Neck Disability Index, Short-Form Health Survey-36 and Tampa Scale of Kinesiophobia.

RESULTS

The EG reduced pain (-40 points, CI95% [-42 to -37], g = -1.03, p < 0.001), EG had less disability (-9.3 points, CI95% [-10.8 to -7.8], g = -1.22, p < 0.001), EG improved the physical dimension of the survey Short-Form Health Survey-36 (4.8 points, CI95% [4.1 to 5.5], g = 0.55, p = 0.01) but had not significant change in psychosocial dimension of the survey Short-Form Health Survey-36 and EG reduced Kinesiophobia (-10.8 points, CI95% [-12.3 to -9.3], g = -1.84, p < 0.001). The CG did not obtain significant results in any variable of the study. Significant differences in change between both groups were found on pain (-11 points, CI95% [5.6 to 16.6], p < 0.001, g = 1.04), disability (-4 points, CI95% [2.5 to 6.2], p < 0.001, g = 1.23), physical dimension of the survey Short-Form Health Survey-36 (3 points, CI95% [-4-4 to -2-5], p = 0.01, g = -1.88), and kinesiophobia ( 7 points, CI95%[-8.3 to -5.4], p < 0.001, g = 2.04), while no significant differences were found on psychosocial dimension of the survey Short-Form Health Survey-36 (-0.02, CI95% [-1.7 to 1.8], g = 0.01, p = 0.98).

CONCLUSIONS

The back school-based programme has beneficial effects on pain, neck disability, the physical dimension of quality of life and kinesiophobia in an adult population with non-specific neck pain. However, it did not lead to improvements in the psychosocial dimension of the participants' quality of life. This programme could be applied by health care providers with the aim of reducing the severe socio-economic impact of non-specific neck pain worldwide. TRIAL REGISTRATION IN CLINICALTRIALS.GOV: NCT05244876 (registered prospectively, date of registration: 17/02/2022).

Validation and cross-cultural adaptation of the postoperative quality of recovery 15 (QoR-15) questionnaire for Spanish-speaking patients: A prospective cohort study

BACKGROUND

The postoperative QoR-15 questionnaire may improve the detection of postoperative complications on an early basis and contribute to optimize treatment and recovery. No validated Spanish QoR-15 questionnaire has been available to date.

METHODS

The Spanish QoR-15 questionnaire (QoR-15E), carried out by official bilingual translators, was administered to 242 adult patients undergoing elective surgery before and 24 h after surgery. Patients were asked about their perceived quality of general recovery using a visual analogue scale (VAS). A random subgroup of 36 patients completed a third questionnaire 30-60 min after having completed the first one, and under the same conditions.

RESULTS

The Pearson correlation coefficient between QoR-15E and the VAS score was 0.759. Cronbach's alpha was 0.856 in the postoperative period. Reliability by the split-half method was 0.781. Test-retest correlation coefficient was 0.998. Cohen's d was 0.94. The mean time to complete the preoperative questionnaire was 2.9 ± 0.5 min.

CONCLUSIONS

The QoR-15E is valid and reliable for assessing postoperative quality of recovery in Spanish-speaking patients, with psychometric and interpretative features similar to those of the original instrument.

Influence of High-Intensity Interval Training on IGF-1 Response, Brain Executive Function, Physical Fitness and Quality of Life in Sedentary Young University Women-Protocol for a Randomized Controlled Trial

Sedentary lifestyles have become a social problem, mainly among women. A sedentary lifestyle has been associated with poorer health in this population, negatively affecting physical and mental health. Physical exercise, in particular high-intensity interval training (HIIT), has been shown to be a neuroprotective tool. The present study provides a protocol design for a parallel-group Randomized Controlled Trial (RCT), whose aim will be to compare the effect of two physical interventions, HIIT and physical activity (increasing daily steps), on Insulin Growth Factor-1 (saliva IGF-1 concentrations), executive functions, quality of life, body composition, physical fitness, and physical activity in young sedentary women. At least 77 women will be recruited and randomly assigned to either a HIIT group (12-week exercise HIIT intervention, 3 sessions/week), the HIIT + PA group (12-week exercise HIIT intervention, 3 sessions/week, plus 10,000 steps/day), or a control group (usual care). The primary outcome measure will the chronic change in IGF-1 concentration levels measured in saliva. Secondary outcome measures will be: (i) executive functions; (ii) body composition; (iii) physical fitness; (iv) physical activity; and (v) quality of life. All outcomes will be assessed at the beginning of the study, after the intervention, and after three months of follow-up. After this intervention, we will be able to determine whether HIIT together with increased physical activity could be more effective than HIIT alone in IGF-1 stimulation. Furthermore, by comparing both intervention groups, we will be able to determine the differential effects on numerous health-related variables. Consequently, the conclusions of this study could help better understand the effects of a training program on IGF-1 concentration levels and executive functions. In addition, various strategies could be proposed through physical exercise to improve cognition in this age group, as well as to improve the health status of this sedentary population.

Physical and mental health impact of the COVID-19 pandemic at first year in a Spanish adult cohort

The COVID-19 pandemic and the political and health measures have profoundly affected the health of our populations. However, very few studies have been published assessing its impact using a prospective cohort. The aim of this study is to describe the impact on physical and mental health due to the COVID-19 pandemic in the general population in Spain, and according to COVID-19 clinical status, during the first year of the pandemic. A longitudinal cohort study with two online surveys were performed on a representative sample of the adult Spanish population before (N = 2005, October/November 2019) and during the pandemic (N = 1357, November/December 2020). We assessed disability using the World Health Organisation Disability Assessment Schedule (WHODAS), major depressive episode (MDE) and suicidal thoughts and behaviours (STB), using an adapted version of the Composite International Diagnostic Interview (CIDI 3.0); generalised anxiety disorder (GAD) using the GAD-7 scale; post-traumatic stress disorder (PTSD) symptoms using the PTSD checklist for DSM-5 (PCL-5). For physical health, there was a statistically significant loss of weight (mean/SD) (T0, 73.22/15.56 vs. T1, 71.21/11.94), less use of tobacco (T0, 11.4% vs. T1, 9.0%) and decreased disability (mean/SD) (T0, 21.52/9.22 vs. T1, 19.03/7.32). For mental health, there was a significant increase in MDE (T0, 6.5% vs. T1, 8.8%) and in the prevalence of GAD (T0, 13.7% vs. T1, 17.7%). The prevalence of STB (T0, 15.1% vs. T1, 7.1%) significantly decreased. Individuals who declared they had been diagnosed with COVID-19 (3.6%) showed a worsening in physical health and an increase in mental health problems and PTSD symptoms. Although suicide risk during the first year of the pandemic was significantly less, many suicide risk factors increased: such as the incidence and persistence of MDE and GAD, the presence of PTSD symptoms in those diagnosed with COVID-19, and a worsening in self-assessed health status. We expect an increase in STB in the population in the long-term. Future research should gather information about the long-term impact of the pandemic.

Patient-Reported Outcomes and Quality of Life After Single-Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy (SADI-S): a Cross-Sectional Study with 283 Patients from a Single Institution

INTRODUCTION

Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is a safe and effective technique with good short- and mid-term weight control and associated medical problems remission for patients with a body mass index (BMI) > 45 kg/m². The aim of this study was to analyze patient-reported symptoms, specifically symptomatic gastroesophageal reflux disease symptoms (GERD), depositional habit, and quality of life (QOL) following SADI-S, using telemedicine and validated tests.

METHODS

A prospective unicentric cross-sectional study was conducted including all patients submitted to SADI-S in the University Hospital of Bellvitge from May 2014 to September 2019. A baseline control group was composed of 67 patients who were planning to undergo SADI-S in the following 4 months. Patients were divided into four groups: pre-SADIS, < 2 years, 2-3 years, and > 3 years after surgery. The information gathered via a telematic questionnaire was analyzed and compared with its presence in patients' clinical history derived from the last presential visit.

RESULTS

The response rate to telematic tests was 86.9%. The mean BMI exhibited significant differences depending on the moment of evaluation: 50.8 kg/m², 30.0 kg/m², 31.1 kg/m², and 32.7 kg/m² at pre-SADIS, < 2, 2-3, and > 3 years follow-up, respectively (p < 0.001). The proportion of GERD symptoms increased over time (17.9%, 18.8%, 26.9%, and 30.2%, p = 0.320). After SADIS, the percentage of patients with loose stools was progressively higher (17.4% vs 25.4% vs 30.2%, p = 0.04). Patients with < 2-year follow-up presented an improvement in both physical component (PCS) and mental component (MCS) summaries compared to the baseline group (PCS = 51.3, and MCS = 49.4). The mean BMI of patients with PCS ≥ 50 was 31.9 kg/m², compared with 41.7 kg/m² in the PCS < 50 group (p < 0.001). In the MCS ≥ 50 group, there were more patients with a BMI < 35 kg/m² than the MCS < 50 group (66.7% vs 48.7%, p = 0.004). Telematic follow-up offered a more systemic and detailed information: in the last presential visit only, 13.9% of patients had complete data regarding weight evolution, remission of associated medical problems, GERD symptoms, and depositional habit in comparison with the 82.9% of patients with telematic follow-up (p < 0.001).

CONCLUSION

Weight control is the main factor related to long-term QOL after SADI-S. The incidence of GERD symptoms and diarrhea was up to 30% in patients with > 3-year follow-up. Monitoring postoperative patient-related symptoms with validated objective tests seems a feasible and useful resource for the long-term follow-up of patients submitted to SADI-S.

Quality of Life, Physical and Mental Health, and Economic Evaluation of Family Caregivers of Chronic Dependent Children: INFAPRINT Cohort Study Protocol

BACKGROUND

Caregivers for children with complex chronic illnesses may experience emotional and physical strain, especially as concerns attention overload and the perceptions of their own psychosocial situation. These concerns, together with the additional financial cost and the socioeconomic inequalities that arise from caregiving responsibilities, create major challenges to the health status of this population group.

METHODS

A prospective analytical longitudinal study will be conducted, based on an exposed cohort of adult caregivers (parents or guardians) for children with complex chronic processes, to evaluate the impact of caregiving responsibilities on the health status of this population group.

CONCLUSIONS AND IMPLICATIONS

The practical implications of this study are of great significance for clinical practice. The results of this study have the potential to inform the decision-making process in the healthcare sector and guide future research initiatives. The findings of this study will provide crucial insights into the health-related quality of life of caregivers of children with complex chronic illnesses, which will be valuable in addressing the challenges faced by this population group. This information can be used to improve the availability and accessibility of appropriate health services and to facilitate the development of more equitable health outcomes for caregivers of children with complex chronic illnesses. By highlighting the extent to which this population is affected both physically and mentally, the study can contribute to the development of clinical practices that prioritize the health and well-being of caregivers in the care of children with complex chronic illnesses.

Adult height and health-related quality of life in patients born small for gestational age treated with recombinant growth hormone

Health related quality of life (HRQoL) is a relevant result when assessing the course of different pathologies and the efficacy of their treatments. HRQoL has been studied previously on adults born small for gestational age (SGA), both in the general population and in patients who had received recombinant human growth hormone (rhGH) treatment, with disparate results. Our study included 50 adults who had received rhGH treatment for the SGA indication in 4 Spanish hospitals. Data have been gathered retrospectively from their clinical records, current weight and height were measured, and patients have been asked to fill out SF-36 and QoLAGHDA quality of life forms, and the Graffar test to evaluate their socio-economical status. Patient's adult height was - 1.2 ± 0.9 SD, lower than their target height of 1 ± 0.8 SD, but gaining 1.7 ± 1 SD from the beginning of the treatment. SF-36 test results showed lower scoring on Mental Health domains than on those related to Physical Health. No correlation was found between HRQoL results and final height, rhGH treatment duration or puberty. Correlation was indeed found between QoLAGHDA and several domains of SF-36, but QoLAGHDA detected fewer patients with low HRQoL than SF-36. Thus, it is concluded that SGA patient's follow-up should include a HRQoL, neuro-cognitive and psychiatric assessment in their transition to adult age. Adult SGA patients without catch up growth have impaired HRQoL, especially in mental health domains.

Effect of Binge-Drinking on Quality of Life in the 'Seguimiento Universidad de Navarra' (SUN) Cohort

BACKGROUND

Binge-drinking is one of the alcohol drinking patterns with the worst health consequences. Nonetheless, binge-drinking is highly prevalent. The perceived benefits that motivate it are ultimately related to subjective well-being. In this context, we analyzed the relationship between binge-drinking and quality of life.

METHODS

We evaluated 8992 participants of the SUN cohort. We classified as binge-drinkers those who reported consuming six or more drinks on at least one occasion the year before recruitment (n = 3075). We fitted multivariable logistic regression models to calculate the odds ratios (ORs) of a worse physical and mental quality of life, measured with the validated SF-36 questionnaire at 8 years of follow-up (cut-off point = P₇₅ or highest score).

RESULTS

Binge-drinking was associated with greater odds of having a worse mental quality of life, even adjusting for quality of life at 4 years of follow-up, used as an approximation to a baseline measure (OR = 1.22 (1.07-1.38)). This value was mainly due to the effects on vitality (OR = 1.17 (1.01-1.34)) and mental health (OR = 1.22 (1.07-1.39)).

CONCLUSIONS

Binge-drinking may lead to poorer mental quality of life; therefore, binge-drinking for enhancement purposes does not seem to be justified by this effect.

[Quality of life and therapeutic adherence in a hypertension program]

OBJECTIVE

To determine the association between treatment adherence and health-related quality of life.

METHODS AND MATERIALS

A cross-sectional investigation was performed in an arterial hypertension program of a general hospital. The Spanish version of the Short Form-36 Health Survey and the Spanish version of the Morisky-Green test. The scores of the subscales and Physical Component (PCS) and Mental Component (MCS) summaries of the SF-36 survey were obtained, then the respective bivariate and multivariate analyzes (Poisson regression) were executed.

RESULTS

39% of patients had therapeutic adherence. All the dimensions of the SF-36 survey presented a statistical association with adherence to antihypertensive treatment. Poisson regression was executed to identify the independent variables associated with obtaining a score higher than 50 in the PCS [presence of comorbidity (risk factor), work status, and therapeutic adherence (protective factor)] and MCS (therapeutic adherence as a protective factor).

CONCLUSIONS

Therapeutic adherence, work status, and absence of comorbidity were associated with a better health-related quality of life.

Multicomponent Training in Progressive Phases Improves Functional Capacity, Physical Capacity, Quality of Life, and Exercise Motivation in Community-Dwelling Older Adults: A Randomized Clinical Trial

OBJECTIVE

To evaluate the effect of a multicomponent progressive training program (MPTP) on functionality, quality of life (QoL) and motivation to exercise (EM) in a group of older adults (OA) of a community.

METHODS

A total of 55 participants of 69.42 ± 6.01 years of age were randomized into two groups; experimental (EG:35) and control (CG:20), and subjected to 27 weeks of MPTP. Functionality (pre/post-intervention) was assessed using the Short Physical Performance Battery (SPPB), Time Up and Go (TUG), Walking While Talking Test (WWT), Manual Dynamometry (MD), Forced Expiratory Volume in the first second (FEV₁), Sit and Reach (SR), Back Scratch (BS), and walk for 2 min (2 mST). QoL was assessed using the SF-36 questionnaire and EM using the BREQ-3. The Kolmogorov-Smirnov and Levene tests were applied. A two-way repeated measures ANOVA was applied. A significance level of p < 0.05 was accepted for all comparisons.

RESULTS

The EG compared to the CG improved in SPPB (ΔEG/CG: 29.67%/p < 0.001), TUG (ΔEG/CG: 35.70%/p < 0.05), WWT (ΔEG/CG: 42.93%/p < 0.001), MD (ΔEG/CG: 20.40%/p < 0.05), FEV₁ (ΔEG/CG: 21.37%/p < 0.05), BS (ΔEG/CG: 80.34%/p < 0.05), 2 mST (ΔEG/CG: 33.02%/p < 0.05), SF-36 (ΔEG/CG: 13.85%/p < 0.001), and Intrinsic Regulation (ΔEG/CG: 27.97%/p < 0.001); Identified by regulation (ΔEG/CG: 9.29%/p < 0.05).

CONCLUSION

An MPTP improves functionality, QoL and EM, and is a safe and effective method for community OAs.

Association between Moderate Alcohol Consumption and Subjective Quality of Life in Spanish Young Adults

BACKGROUND

For the last 25 years, the debate on the benefit-risk balance of moderate alcohol consumption has been ongoing. This study explored the relationships between the pattern of alcohol consumption and subjective quality of life in healthy adults.

MATERIAL AND METHODS

Participants were 247 healthy adults aged 25-45 years, with a moderate alcohol consumption, classified in three groups of alcohol intake: None (N = 37; <0.7 g/day), Low (N = 87; 0.7-<5 g/day) and Medium (N = 123; 5-16 g/day in women and 5-28 g/day in men). Information was collected with questionnaires including: alcoholic beverage frequency and pattern, quality of life (SF-36v2), anxiety, depression, health condition, adherence to the Mediterranean diet, physical activity and sleep time.

RESULTS

Mean (SD) age of participants was 35.9 (6.3). In the Medium group, the mean alcohol intake was 10.98 ± 4.84 g/day on weekly bases and 24.7 ± 15.2 g/day on weekend days. Beer was the main contributor to total daily alcohol consumption. The percentage of subjects in the Medium group that showed a weekend average intake higher than moderate was 58.5% in exclusively weekend consumers and 48.2% in those who are not exclusive-weekend consumers (p = 0.278). Regarding markers of quality of life and mental health, the results did not show any significant association with alcohol consumption. In conclusion, in subjects that show weekly bases moderate intake of alcohol, weekend-day consumption levels can be high; however, no association of an overall moderate alcohol consumption pattern with quality of life was found.

Profiles of women who have suffered occupational accidents in cleaning: perceived health, psychosocial risks, and personality variables

PURPOSE

The main goal was to identify the variables (sociodemographic, work, psychosocial, perceived health, and personality) associated with occupational accidents suffered in the past by women in the cleaning sector.

METHODS

A sample of 455 women was evaluated.

RESULTS

A total of 23.5% of the workers (n = 107) had suffered an occupational accident with medical leave. In general, women who had suffered some accident in their life had a worse situation in all areas evaluated. Two subsamples of women had a greater association with accidents. Specifically, the presence of work accidents was 15.9 times higher among those who presented a worse perception of their physical effort and a greater tendency towards risky behaviours and 13.5 times higher among those who had a moderate perception of physical exertion and a disability.

CONCLUSION

In general, the characteristics of female workers were found to be associated with different accident rates. Preventive actions should be designed individually.

Translation, Cultural Adaptation, and Validation of the American Orthopedic Foot and Ankle Society Scale in Patients With Hallux Valgus in Colombia

The American Orthopedic Foot and Ankle Society (AOFAS) scale for hallux metatarsophalangeal (MTP) and interphalangeal (IP) joints is used throughout the world for the clinical assessment of patients with hallux valgus, and it has 3 subscales: pain, function, and alignment. The objective of this prospective, observational study was to perform translation, cultural adaptation, and validation of this scale for Colombian Spanish. The Foot Function Index and Short Form-36 (SF-36) questionnaires were also used in the validation process. Patients who were 18 years or older, resided in the city of Bogota, were able to read and write in Spanish, and were within 4 years of corrective surgery for hallux valgus were included. A total of 79 patients were included in the study, 25 of whom were involved in the translation process and all of whom were involved in the validation process. Construct validity was demonstrated by significant positive Spearman's correlations between the AOFAS pain subscale and the AOFAS function subscale (r_s = 0.483), total AOFAS scale (r_s = 0.795), and SF-36 physical summary subscale (r_s = 0.364); and between the AOFAS function subscale and the total AOFAS scale (r_s = 0.894) and SF-36 physical summary subscale (r_s = 0.310). The test-retest process for reliability yielded intraclass correlation coefficients between the AOFAS pain, function, and alignment subscales that were all 0.70 or higher. The AOFAS scale for hallux MTP and IP joints was successfully translated and adapted into Colombian Spanish, and this version demonstrated construct validity and reliability, rendering it suitable for clinical use in Colombian patients with hallux valgus.

Effects of a multicomponent physical exercise programme on perceived health-related quality of life and on depressive symptoms in older adults living in long-term nursing homes

Objectives

This study aimed to investigate the impact of a multicomponent exercise programme on perceived health-related quality of life (HRQoL) and depressive symptomatology in older people living in a long-term nursing home (LTNH).

Methods

A quasi-experimental study was conducted. Forty-one older people were conveniently selected from the largest LTNH in the Basque Country. The participants were assigned to either an intervention group (n = 21) or a control group (n = 20). The intervention group participated in 50-min moderate intensity multicomponent physical exercise sessions (strength and balance, three sessions a week for 3 months). The control group participants continued their usual activities in the LTNH. Assessments were completed at baseline and reassessed after the 12-week intervention by the same nurse researchers who filled out the questionnaires: the 36-item Short Form Survey (SF-36) and the Geriatric Depression Scale (GDS).

Results

Thirty-eight participants completed the study (19 participants in each group). In the SF-36 parameters, physical functioning increase in the intervention group tends with a mean increase of 11.06 units (a 17.2% increase over the pre). In the role-emotional, the increase in the intervention group is with a mean increase of 5.27 units (a 29.1% increase over the pre) (P < 0.05). In social functioning, the increase in the control group is significant with a mean increase of 13.16 units (a 15.4% increase over the pre) (P < 0.05). There are no significant changes in the rest of the parameters, there are no differences between groups in the evolutionary pattern either.

Conclusions

As for the effects of the multicomponent exercise programme on HRQoL and depressive symptomatology, no statistically significant effects were obtained in the outcome data among older adults living in LTNHs. An increase in the sample size could confirm the trends obtained. The results may help inform the design of future studies.

The relationship between perceived health and psychosocial risk in women in the service sector (cleaning)

BACKGROUND

Cleaning is considered a female-dominant occupation. Women cleaning workers present a high risk of suffering impaired health probably as a result of performing low-skilled tasks. However, to date, no studies have been found that examine the health status of female cleaning workers in Spain.

OBJECTIVES

The objectives were to 1) determine the level of perceived health in a sample of female cleaning workers, 2) evaluate the main psychosocial risks they face, 3) explore the relationship between perceived health and psychosocial risk factors, and 4) compare the perceived health of those women who present some psychosocial risk factor and those who do not.

METHODS

This is a multi-centered cross-sectional study carried out in the service sector of a Spanish company. The final sample was composed of 455 female cleaning workers. Sociodemographic variables, perceived health status and psychosocial risk factors were assessed.

RESULTS

Women presented a high perception of health status. The main psychosocial risk was lack of acknowledgement by their superiors, which affected 25.2% (n = 111) of the sample. Moderate negative correlations (r=-.222 to -.442; p <  .01) were identified between perceived health and evident psychosocial risks. Those women who presented some psychosocial risk (n = 174; 38.3%) had a worse state of perceived health in all variables studied.

CONCLUSION

Presence of psychosocial risk had a relationship with a worse health perception. This article highlights the need to orient preventive actions in the psychosocial field. The COVID-19 pandemic represents a new situation to renew the health promotion between cleaning workers.

Índice de calidad de vida percibida en pacientes con trastornos gastrointestinales funcionales en Buenos Aires, Argentina

Los trastornos gastrointestinales funcionales (tgf) son enfermedades crónicas que configuran un problema relevante en la salud pública, asociados en investigaciones previas a una peor calidad de vida. El objetivo del presente trabajo fue estudiar la calidad de vida en pacientes que acuden a un servicio de neurogastroenterología en un hospital de Argentina ycompararlo con población control. Para ello, se realizó un estudio cuantitativo y transversal incluyendo población clínica diagnosticada con algún tgf (n = 35) y una muestra control sin diagnóstico de tgf (n = 37). Se encontraron diferencias significativas entre personas con tgf y sujetos control, χ² (1, n = 70) = 30.23, p < .001 en todas las subdimensiones de la escala de calidad de vida (mqli), exceptuando satisfacción espiritual (pe). Similar a investigaciones previas, los resultados de este estudio sugieren que, en Argentina —al igual que en otros países—, los individuos con tgf muestran una peorpercepción de calidad de vida que la población general. Estos hallazgos podrían contribuir al diseño de intervenciones que contemplen variables biopsicosociales, con el objetivo de una mejoría integral en la calidad de vida de las personas que padecen estos trastornos.

Health-Related Quality of Life, Pain and Sleep in Patients with HIV Depending on the Clinical Situation: A Cross-Sectional Pilot Study

Introduction: Health-related quality of life (HRQL), pain and sleep have been described as relevant traits in patients with human immunodeficiency virus (HIV). The aim of this study is to describe and evaluate HRQL, pain and sleep and their interdependence in HIV-positive patients. Methods: A cross-sectional study on HIV-infected patients was conducted. A set of five different questionnaires was used: two questionnaires addressing HRQL (Short Form 36 [SF-36] Health Survey and Medical Outcomes Study Short Form 30 [MOS-SF 30]), one on pain (McGill Pain Questionnaire) and one on sleep (Pittsburgh Sleep Quality Index [PSQI]). We also collected the sociodemographic and clinical characteristics of patients. Results: The sample included 109 patients (age: 46.08 ± 10.49 years; 68.8% male). The pain experience was independent of HRQL and sleep. Relationships among HRQL, pain and sleep associated to sociodemographic and clinical factors were not detected (p > 0.05). Patients with CDC category A showed moderate to high correlations among HRQL, pain and sleep. In CDC B-type patients, a moderate correlation was observed between pain and mental health. In CDC C patients, moderate correlations were observed between HRQL and sleep and pain and sleep, with no correlations between HRQL and pain. Conclusions: HRQL, pain and sleep are differently correlated in HIV patients depending on their clinical stage. Neither the nadir of CD4-T cells nor the current count of CD4-T cells was found to be related with HRQL, pain or sleep.

Health self-perception is associated with life-styles and comorbidities and its effect on mortality is confounded by age. A population based study

Background

Health self-perception (HSP) is the individual and subjective concept that a person has of their state of health. Despite its simplicity, HSP is considered a valid and relevant indicator employed in epidemiological research and in professional practice as an overall measure of health.

Objectives

(1) To describe and analyze the associations between HSP and demographic variables, lifestyle and diseases prevalent in a population and (2) to investigate the relationship between HSP and mortality.

Materials and methods

In a primary care setting, we conducted a longitudinal study of a random populational sample of a Galician municipality, stratified by decade of life. A total of 1,516 adults older than 18 years, recruited by the 2013-2015 AEGIS study, were followed-up for more than 5 years. During the clinical interview, data were collected on lifestyle and prevalent diseases. The HSP was grouped into 2 categories (good/poor). The statistical analysis consisted of a logistic regression, Kaplan-Meier curves and Cox regression.

Results

A total of 540 (35.6%) participants reported poor HSP. At the end of the follow-up, 78 participants had died (5.1%). The participants with increased age and body mass index and chronic diseases (anxiety, depression, ischemic heart disease, diabetes, and cancer) presented a poorer subjective health. A high level of physical activity and moderate alcohol consumption were associated with better HSP. A poorer HSP was associated with increased mortality, an association that disappeared after adjusting for the rest of the covariates (HR, 0.82; 95% CI 0.50-1.33).

Conclusion

(1) Health self-perception is associated with age, lifestyle, and certain prevalent diseases. (2) A poorer HSP is associated with increased mortality, but this predictive capacity disappeared after adjusting for potential confounders such as age, lifestyle, and prevalent diseases.

Mental health inequalities in times of crisis: evolution between 2005 and 2021 among the Spanish salaried population

BACKGROUND

Studying the working population's mental health in times of crisis (such as the 2008 recession or the COVID-19 pandemic) is very relevant. This study aims to assess the prevalence of poor mental health among the Spanish salaried population, according to the labour market inequality axes (2005-2021).

METHODS

Repeated cross-sectional study by comparing different surveys from 2005, 2010, 2016 and 2021 on workers residing in Spain who had been working in a salaried job during the week preceding the survey. n=7197 (2005), n=4985 (2010), n=1807 (2016) and n=18 870 (2021).

OUTCOME VARIABLE

poor mental health (Mental Health Inventory of the 36-item Short Form Health Survey scale). Explanatory variables: gender, age, occupational class and type of contract. Prevalence of poor mental health was estimated for each year by means of logistic regression models with robust clustered SEs, stratifying by the explanatory variables. Additionally, prevalence ratios (PR) were estimated by means of robust Poisson regression models to assess differences between the explanatory variables' categories. All analyses were weighted to address unrepresentativeness.

RESULTS

Poor mental health significantly increased in 2021 (55.92%), compared with the previous years of study (15%-17.72%). Additionally, pattern changes were identified on inequality axes in 2021, with better mental health status among older workers (oldest group PR: 0.76; 95% CI 0.71 to 0.8) and permanent workers (PR: 0.9; 95% CI 0.85 to 0.94).

CONCLUSION

This study shows a steep worsening of mental health among the salaried population in 2021 compared with previous periods. In 2021, health inequalities have apparently narrowed, although not by improving the disadvantaged groups' mental health but by worsening the typically advantaged groups' mental health.

Mortality and Quality of Life with Chronic Kidney Disease: A Five-Year Cohort Study with a Sample Initially Receiving Peritoneal Dialysis

The quality of life, morbidity and mortality of people receiving renal replacement therapy is affected both by the renal disease itself and its treatment. The therapy that best improves renal function and quality of life is transplantation. Objectives: To study the quality of life, morbidity and mortality of people receiving renal replacement therapy over a five-year period. Design: A longitudinal multicentre study of a cohort of people with chronic kidney disease. Methods: Patients from the Girona health area receiving peritoneal dialysis were studied, gathering data on sociodemographic and clinical variables through an ad hoc questionnaire, quality of life using the SF-36 questionnaire, and social support with the MOS scale. Results: Mortality was 47.2%. Physical functioning was the variable that worsened most in comparison with the first measurement (p = 0.035). Those receiving peritoneal dialysis (p = 0.068) and transplant recipients (p = 0.083) had a better general health perception. The social functioning of transplant recipients improved (p = 0.008). Conclusions: People with chronic kidney disease had a high level of mortality. The dimension of physical functioning worsens over the years. Haemodialysis is the therapy that most negatively effects general health perception. Kidney transplantation has a positive effect on the dimensions of energy/vitality, social functioning and general health perception.

Home-Based Respiratory Physiotherapy and Telephone-Based Psychological Support for COVID-19 Survivors in Peru: Protocol for a Randomized Controlled Trial

BACKGROUND

Both pulmonary and mental health are affected following hospitalization for COVID-19 pneumonia. Pulmonary rehabilitation therapy has demonstrated benefits in improving mental health, but no validated combined programs that include mental health have been proposed.

OBJECTIVE

This article presents the design of a trial that aimed to assess whether the participation in a combined rehabilitation program that includes home-based respiratory physiotherapy and telephone-based psychological support is associated with a greater improvement of pulmonary and mental health outcomes 7-12 weeks after COVID-19 hospitalization discharge compared with posthospital usual care provided by a public Peruvian hospital.

METHODS

WAYRA (the word for air in the Quechua language) was an open-label, unblinded, two-arm randomized controlled trial. We recruited 108 participants aged 18-75 years who were discharged from the hospital after COVID-19 pneumonia that required >6 liters/minute of supplemental oxygen during treatment. Participants were randomly assigned at a 1:1 ratio to receive the combined rehabilitation program or usual posthospital care provided by a public Peruvian hospital. The intervention consisted of 12 at-home respiratory rehabilitation sessions and 6 telephone-based psychological sessions. The primary outcome was the 6-minute walk distance. Secondary outcomes included lung function, mental health status (depression, anxiety, and trauma), and quality of life. Outcomes were assessed at baseline (before randomization) and at 7 and 12 weeks after hospital discharge to assess the difference between arms.

RESULTS

This study was funded by the Peruvian National Council of Science Technology and Technology Innovation in July 2020. Ethics approval was obtained on September 2, 2020. Recruitment and data collection occurred between October 2020 and June 2021. Results are expected to be published by the end of 2022.

CONCLUSIONS

WAYRA was the first randomized controlled trial evaluating combined pulmonary-mental health rehabilitation for hospitalized COVID-19 survivors in resource-limited settings, potentially providing a foundation for the cost-effective scale-up of similar multidisciplinary rehabilitation programs.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04649736; https://clinicaltrials.gov/ct2/show/NCT04649736.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR1-10.2196/36001.

Factors Associated with Poor Health-Related Quality of Life in Physically Active Older People

This study aimed to associate morphological variables and physical fitness with health-related quality of life (HRQoL) in physically active older people. A cross-sectional study was carried out that evaluated 470 older people (89.57% female) with a mean age of 70.13 ± 6.57 years, residing in two regions of Chile. Morphological variables (body weight, bipedal height, waist circumference, body mass index, and waist to height ratio), physical fitness through the Senior Fitness Test protocol, and HRQoL using the SF-36 questionnaire were obtained. Logistic regression analysis was used to identify risk factors between morphological variables and physical fitness associated with HRQoL. The main results indicated that overweight (OR = 1.52; p = 0.034), a waist circumference with risk (OR = 1.56; p = 0.021), poor performance in the back scratch tests (OR = 1.02; p = 0.008) and timed up-and-go (OR = 1.19; p = 0.040) increased the probability of having a low general HRQoL. Also, the low performance of chair stand and arm curl tests was associated with poor physical and social dimensions of HRQoL (p < 0.05). In conclusion, a low HRQoL in physically active older people is associated with both morphological and physical fitness factors.

Deloyers procedure compared to ileorectal anastomosis as restoration techniques of bowel continuity after extended left colon resection

BACKGROUND

Restoration of bowel continuity after left extended colectomy may be challenging because the remaining colon may not reach the rectal stump without tension to perform a safe anastomosis. Performing a total colectomy with ileorectal anastomosis (IRA) is an option, but the quality of life can be significantly impaired due to loose stools and an increase in bowel frequency. In contrast, the preservation of the right colon and ileocaecal valve in the Deloyers procedure (DP) might ensure a better stool consistency and bowel transit, and therefore a superior quality of life.

MATERIALS AND METHODS

A transverse study comparing patients that underwent DP versus patients with an IRA was performed. Postoperative morbidity, mortality, functional outcomes, and quality of life were analysed between groups. Quality of life after the surgical procedure was assessed with the SF-36 V2® health survey.

RESULTS

A total of 16 patients with DP and 32 with IRA were included. The groups had similar demographic characteristics concerning age, sex, body mass index, ASA classification, diagnosis and Charlson comorbidity index. The median follow-up was 55 months for DP and 99 months for IRA. Postoperative complications were similar in both groups. Patients in the DP group had fewer bowel movements (P = 0.01), tenesmus (P = 0.04) and use of loperamide (P = 0.03). DP patients achieved better scores in physical pain (P = 0.02) and general health (P < 0.01) than IRA patients.

CONCLUSIONS

DP for intestinal continuity restoration after extended left colon resection is a safe and feasible alternative, possibly achieving better functional outcomes and quality-of-life compared to IRA.

A socio-ecological approach to reduce the physical activity drop-out ratio in primary care-based patients with type 2 diabetes: the SENWI study protocol for a randomized control trial

Background

Physical activity (PA) is a key behaviour for patients with type 2 diabetes (T2DM). However, healthcare professionals’ (HCP) recommendations (walking advice), which are short-term and individually focused, did not reduce the PA drop-out ratio in the long run. Using a socio-ecological model approach may contribute to reducing patient dropout and improving adherence to PA. The aim of this study is threefold: first, to evaluate the effectiveness of a theory-driven Nordic walking intervention using a socio-ecological approach with T2DM patients in Spain; second, to explore the feasibility on the PA adherence process in T2DM patients while participating in the SENWI programme; and third, to understand the HCPs’ opinion regarding its applicability within the Spanish healthcare system.

Methods

A three-arm randomized control trial (n = 48 each group) will assess the efficacy of two primary care-based PA interventions (Nordic walking vs. Nordic walking plus socio-ecological approach; two sessions per week for twelve weeks) compared to a control group (usual HCPs’ walking advice on PA). Inclusion criteria will include physically inactive patients with T2DM, older than 40 years and without health contraindications to do PA. PA levels and drop-out ratio, quality of life and metabolic and health outcomes will be assessed at baseline, post-intervention and at 9- and 21-month follow-ups. The effect of the different interventions will be assessed by a two-factor analysis of variance: treatment group vs time. Also, a two-factor ANOVA test will be performed with linear mixed models for repeated measures.

A qualitative analysis using focus groups will explore the reasons for the (in)effectiveness of the new PA interventions. Qualitative outcomes will be assessed at post-intervention using thematic analysis.

Discussion

Compared with the general PA walking advice and Nordic walking prescriptions, integrating a socio-ecological approach into Spanish primary care visits could be an effective way to reduce the PA drop-out ratio and increase PA levels in patients with T2DM. Such interventions are necessary to understand the role that multiple socio-complex process in day-to-day PA behaviour has in patients with T2DM in the Spanish context.

Trial registration

ClinicalTrials.gov NCT05159089. Physical Activity Drop-out Ratio in Patients’ Living with Type 2 Diabetes. Prospectively registered on 15 December 2021.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-022-06742-7.

[Evolution and quality of life at three months after hospitalization for COVID pneumonia]

OBJECTIVE

Assess clinical evolution and health-related quality of life at three months after discharge in patients who were admitted and diagnosed with COVID-19 pneumonia, evaluated by the Rehabilitation Service and received physiotherapy in Fuenlabrada Hospital.

METHODS

Data were collected from 59 patients, separating those who were assessed in ICU (41 patients) from those assessed in the hospital ward (18). Data were obtained from their Electronic Medical Record, and a telephone interview was performed three months after their discharge. Data about their clinical progress during their hospitalization, after discharge, over the next months and their condition at the time of the interview is analyzed. Patients were asked to assess the quality of the physiotherapy received and to answer the SF-36 health-related quality of life questionnaire.

RESULTS

These patients had the worst progress of the COVID pneumonia among all patients hospitalized in our hospital, but they had a good functional recovery with the inpatient physiotherapy received, which was positively rated. After three months, 84% have persistent symptoms, with the most common being dyspnoea, fatigue and anxiety/depression, and score worse in the SF-36 questionnaire than the reference population.

CONCLUSIONS

Most patients who require rehabilitation during their COVID pneumonia admission have persistent symptoms and perceive a deterioration in their health-related quality of life after three months of discharge.

Quality of Life in the Postpartum Recovery of Women Who Practice Hypopressive Exercise: Randomized Clinical Trial

Background: Practicing physical exercise is a way of maintaining a healthy lifestyle and it has been demonstrated to provide benefits and improve quality of life after labour. Aim: The objective of this study is to determine if performing a moderate hypopressive exercise program after childbirth improves the HRQoL of women. Materials and Methods: A 12-week randomized clinical trial was carried out. The women in the exercise group followed a training program based on the hypopressive method, which comprises postural and respiratory exercises of moderate intensity. We used the SF-36v2 questionnaire to assess the Health-Related Quality of Life in women. Results: We found statistically significant differences (p < 0.05) in general health components, vitality, emotional role, and mental health in the sample group of exercise group of women, who obtained a higher score. We found statistically significant differences in all aspects between the groups. The interaction between time and group affect in general health components, vitality, emotional role and the score of mental components. In all of them, the score was higher at the end of the programme and in the exercise group. Conclusions: The training program with hypopressive physical exercise improves the quality of life after childbirth. According to the guidelines recommended by the ACOG, the hypopressive method is valid for the improvement of HRQoL in women who perform this method at 16 weeks of delivery. Further studies are recommended to start such exercises one week after delivery in postpartum women.

Women during Lactation Reduce Their Physical Activity and Sleep Duration Compared to Pregnancy

Sleep, mental health and physical activity are fundamental for wellbeing, and some of these factors are interrelated. However, these aspects are not usually considered during pregnancy and lactation, which are particularly vulnerable periods. Therefore, our aims were to conduct a cross sectional study to assess the psychological capital, quality of life, sleep hygiene and physical activity in a cohort of women during pregnancy and lactation periods. Women were recruited from Spanish maternity and lactation non-profit associations and social networks through an online platform with the following inclusion criteria: pregnancy (in any period of gestation) or breastfeeding period (≤6 months postpartum). The cohort was categorized into ≤12 weeks of gestation (n = 32), >12 weeks of gestation (n = 119) and lactation (n = 60). The women self-reported the sociodemographic data, obstetric complications and full breastfeeding or mixed practices. In addition, women responded to the psychological capital instrument, the health survey form, the Pittsburg sleep quality index and the pregnancy physical activity questionnaire. Overall, the groups were similar in sociodemographic variables. Women in the lactation period perceived lower social support compared to the gestation period. No statistically differences were found between groups in the psychological capital nor in the general health survey form. However, the models adjusted by employment and civil and economic status and perceived social support, demonstrated that the sleep duration negatively associated with the lactation period (β = 1.13 ± 0.56; p-Value = 0.016), and the household tasks were associated with this period (β = 2147.3 ± 480.7; p-Value < 0.001). A decrease in physical daily activities were associated with both the end of gestation and the lactation periods. In addition, the decreasing total activity was associated with the lactation period (β = 1683.67 ± 688.05; p-Value = 0.016). In conclusion, during lactation, the poorer sleep and physical activity, together with a lower social support of the woman, may lead to deficient mental health adjustment. Our data suggest that women are at higher risk of vulnerability in lactation compared to the gestation period.

Possible metabolic interplay between quality of life and fecal microbiota in a presenior population-Preliminary results

OBJECTIVES

The number of people aged ≥60 y is increasing worldwide, so establishing a relationship between lifestyle and health-associated factors, such as gut microbiota in an older population, is important. This study aimed to characterize the gut microbiota of a presenior population, and analyze the association between some bacteria and quality of life with the Short Form (SF) 36 questionnaire.

METHODS

Participants were adult men and women ages 50 to 80 y (n = 74). In addition to the SF-36 questionnaire, fecal samples were collected in cryotubes, and 16S RNA gene sequencing was performed to characterize microbial features. Participants were classified into two groups according to SF-36 punctuation. Linear and logistic regression models were performed to assess the possible association between any bacterial bowl and SF-36 score. Receiver operating characteristics curves were fitted to define the relative diagnostic strength of different bacterial taxa for the correct determination of quality of life.

RESULTS

A positive relationship was established between SF-36 score and Actinobacteria (P = 0.0310; R = 0.2510) compared with Peptostreptococcaceae (P = 0.0259; R = -0.2589), which increased with decreasing quality of life. Logistic regressions models and receiver operating characteristics curves showed that the relative abundance of Actinobacteria and Peptostreptococcaceae may be useful to predict quality of life in a presenior population (area under the curve: 0.71).

CONCLUSIONS

Quality of life may be associated with the relative abundance of certain bacteria, especially Actinobacteria and Peptostreptococcaceae, which may have a specific effect on certain markers and health care, which is important to improve quality of life in older populations.

Psychometric Properties of the Emotional Eater Questionnaire in University Students

Emotional Eating (EE) patterns have been shown to play a relevant role in the development of overweight and obesity. The aim of this study was to analyze the factor structure and psychometric properties of the Emotional Eater Questionnaire (EEQ) in university students from Huelva. The EEQ was administered to 1282 students (age 22.00 (±5.10), BMI 23.59 (±6.74)), belonging to the University of Huelva. An exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were carried out. The internal structure of the questionnaire, internal consistency, test-retest reliability, and convergent validity were analyzed. Principal component analysis of the questionnaire showed two dimensions, explaining 56% of the variance. Internal consistency showed a Cronbach's alpha of 0.859 globally, and of 0.841-0.855 if the items were removed. The corrected item-total correlation yielded values of 0.444-0.687. The test-retest stability was ICC = 0.924 (p < 0.001). The data showed significant correlations between EEQ and the rest of the variables, and a Spearman's Coefficient ranging from -0.367 to 0.400. The fit indexes were good for the confirmatory factor analysis. The results obtained with this structure found an adequate reliability and validity of the questionnaire in comparison with previous studies.

EMAeHealth, a digital tool for the self-management of women's health needs during pregnancy, childbirth and the puerperium: protocol for a hybrid effectiveness-implementation study

INTRODUCTION

EHealth can help health service users take a more active role in decision-making and help health professionals guide the patient in this process. A digital tool has been designed to support maternal education (ME), and it is organised into four areas: (1) information, (2) communication, (3) health self-management and (4) clinical data. The main objective of the study is to evaluate the effectiveness of the EMAeHealth digital tool, and assess its usability and acceptability under routine conditions.

METHODS AND ANALYSIS

Hybrid implementation-effectiveness design: (1) A cluster randomised, prospective, longitudinal, multicentre clinical trial to evaluate the effectiveness of EMAeHealth in (A) improving health-related quality of life (primary outcome), (B) improving self-efficacy for labour and childbirth and self-efficacy in breast feeding and (C) reducing the number of visits to the obstetric emergency services and health centre in situations of 'non-pathological pregnancy', 'false labour pains' and 'non-pathological puerperium'. The EMAeHealth intervention plus usual care will be compared with receiving only usual care, which includes traditional ME. N=1080 participants, 540 for each study arm. Two measurements will be made throughout the pregnancy and three in the first 16 weeks post partum. (2) A mixed-method study to evaluate the usability and acceptability of the tool, barriers and facilitators for its use, and implementation in our health system: focus groups (women, professionals and agents involved) and a quantitative analysis of implementation indicators.

ANALYSIS

It will be carried out by intention to treat, using mixed models taking into account the hierarchical structure of the data and per protocol to evaluate the effectiveness of the express use of the digital tool.

ETHICS AND DISSEMINATION

Clinical Research Ethics Committee of Euskadi, Spain, (Ref: PI2020044) approved this study. The results will be actively disseminated through manuscript publications and conference presentations.

TRIAL REGISTRATION NUMBER

NCT04937049.

Changes in life satisfaction, depression, general health and sleep quality of Spanish older women during COVID-19 lockdown and their relationship with lifestyle: an observational follow-up study

OBJETIVES

To analyse the effects of COVID-19 lockdown on mental well-being variables of older women, and to determine the influence of lifestyle and age on such effects. The hypothesis of the study was that all parameters related to mental well-being would worsen in older women during the COVID-19 lockdown.

DESIGN

Observational follow-up study. Pre lockdown measurements were taken before the lockdown. Post lockdown measurements were taken as soon as began the de-escalation.

SETTING

Senior centres in the Region of Murcia (Spain).

PARTICIPANTS

The sample was composed of 40 older women volunteers, over 54 years of age (mean age=62.35±8.15 years).

PRIMARY AND SECONDARY OUTCOME MEASURES

Pre lockdown and post lockdown evaluations were carried out face to face. The following questionnaires were completed: Satisfaction with Life Scale, The Center for Epidemiologic Studies Depression Scale, The Short Form 36 Health Survey, The Pittsburgh Sleep Quality Index, the Global Physical Activity Questionnaire and Prevention with Mediterranean Diet.

RESULTS

Post lockdown, a worsening was found in the variables of life satisfaction (p=0.001); depression (p<0.001), quality of life in physical role (p=0.006), pain (p=0.004), emotional role (p<0.001) and mental health (p<0.001); and sleep quality (p=0.018), sleep latency (p=0.004), sleep disturbances (p=0.002) and global sleep quality score (p=0.002). It was found how age influenced the variables of pain (p=0.003) and social role (p=0.047), as well as the influence of a healthy lifestyle on the variables analysed (F=6.214; p=0.017). Adherence to the Mediterranean diet was shown to be a protective factor against increased depression (p=0.03). Spending time sitting was shown to be a risk factor for physical role health (p=0.002), as was advanced age on health due to worsening pain (p=0.005), or an unhealthy lifestyle on increased consumption of sleeping aids (p=0.017).

CONCLUSION

The lockdown had a great negative impact on Spanish older women on mental well-being variables.

TRIAL REGISTRATION NUMBER

NCT04958499.

Impact of COVID-19 on Health-Related Quality of Life: A Longitudinal Study in a Spanish Clinical Sample

SARS-CoV-2 respiratory infection and the course of its sequelae remain to be defined. The aim of this study is to analyze health status and Health-Related Quality of Life (HRQoL) in a Spanish sample of survivors of coronavirus disease 2019 (COVID-19) pneumonia.

METHODS

Prospective observational study of patients who survived SARS-CoV-2 pneumonia, between February 2020 and May 2020, with systematic evaluation at 3 and 12 months after the onset of the disease. The data were obtained by reviewing the clinical history and performing a physical examination, a chest X-ray, and a pulmonary function test on the patients. Additionally, the SF-36 questionnaire was administered for the HRQoL study.

RESULTS

In total, 130 patients aged 55.9 ± 15.9 years were included. Dyspnea (36.9%) and asthenia (36.2%) were the most frequent persistent symptoms. Fibrotic pulmonary changes were detected in 20.8% of the participants. Compared to the general population, significant deterioration was detected in all domains of the SF-36 questionnaire at 3 and 12 months post-COVID-19 infection. The greatest differences were in the physical role (RF) and in the emotional role (RE).

CONCLUSIONS

COVID-19 pneumonia causes a long-term deterioration in HRQoL compared to the general population. Over time, a trend toward improvement is detected in most domains of the SF-36.

Predominant approaches in studies on health-related quality of life of young survivors of childhood or adolescent cancer: an integrative literature review

Abstract Survivors of childhood cancer constitute a growing population. The disease experienced, its treatment or the occurrence of late complications may affect survivors’ health-related quality of life (HRQOL). Understanding HRQOL is a challenge due to its conceptual complexity and the mode in which it is studied. Objective: To identify the predominant lines of research in the study of HRQOL in this population. Methods: An integrative literature review was carried out, involving a systematic search of primary articles indexed in the Scopus and PubMed databases. Results: In the 48 publications selected, four main lines of research were identified: HRQOL in survivors in general; HRQOL in long-term survivors; the study of determinants of HRQOL; and the study of methodological aspects of HRQOL measurement. A quantitative approach using generic measurement instruments predominates, and the conceptual model of HRQOL based on function emphasizes the importance of physical, psychological, and social functionality and the impact of the disease and treatment on these aspects. Conclusions: incorporating a qualitative, meaning-based approach to the understanding of lived experiences from a subjective and holistic perspective is indispensable.

Predominant approaches in studies on health-related quality of life of young survivors of childhood or adolescent cancer: an integrative literature review

Survivors of childhood cancer constitute a growing population. The disease experienced, its treatment or the occurrence of late complications may affect survivors' health-related quality of life (HRQOL). Understanding HRQOL is a challenge due to its conceptual complexity and the mode in which it is studied.

OBJECTIVE

To identify the predominant lines of research in the study of HRQOL in this population.

METHODS

An integrative literature review was carried out, involving a systematic search of primary articles indexed in the Scopus and PubMed databases.

RESULTS

In the 48 publications selected, four main lines of research were identified: HRQOL in survivors in general; HRQOL in long-term survivors; the study of determinants of HRQOL; and the study of methodological aspects of HRQOL measurement. A quantitative approach using generic measurement instruments predominates, and the conceptual model of HRQOL based on function emphasizes the importance of physical, psychological, and social functionality and the impact of the disease and treatment on these aspects.

CONCLUSIONS

incorporating a qualitative, meaning-based approach to the understanding of lived experiences from a subjective and holistic perspective is indispensable.

Active and sham transcranial direct current stimulation (tDCS) improved quality of life in female patients with fibromyalgia

PURPOSE

Fibromyalgia (FM) is a chronic pain syndrome with a strong impact on quality of life (QoL). Treatment of this condition remains a challenge, due to the scarce evidence for the effectiveness of the therapeutic approaches available. Current attention is focused on transcranial direct current stimulation (tDCS), which has yielded promising results for pain treatment. Rather than focusing only on pain relief, in this study, we aimed to determine how active or sham tDCS (over three cortical targets -the primary motor cortex, the dorsolateral prefrontal cortex and the operculo-insular cortex-) affect QoL in patients with FM.

METHODS

Using a double-blind, placebo-controlled design, we applied fifteen tDCS sessions of 20' to initial 130 participants (randomized to any of the four treatment groups). We evaluated the QoL (assessed by SF-36) and the symptoms' impact (assessed by FIQ-R) in baseline, after treatment and at 6 months follow-up.

RESULTS

All groups were comparable as regards age, medication pattern and severity of symptoms before the treatment. We found that QoL and symptoms' impact improved in all treatment groups (including the sham) and this improvement lasted for up to 6 months. However, we did not observe any group effect nor group*treatment interaction.

CONCLUSIONS

After the intervention, we observed a non-specific effect that may be due to placebo, favoured by the expectations of tDCS efficacy and psychosocial variables inherent to the intervention (daily relationship with therapists and other patients in the clinic). Therefore, active tDCS is not superior to sham stimulation in improving QoL in FM.

Effectiveness of a Fibromyalgia Online Nursing Consultation in the Quality of Life: A Randomized Controlled Trial

BACKGROUND

Aim: To evaluate the effectiveness of an online nursing consultation through the Internet platform Red Sinapsis (RS) in improving the perceived quality of life of patients with fibromyalgia (FM).

METHOD

Eighty patients with FM were randomized to an intervention group (n = 40) or control group (n= 40). The intervention group (IG) was monitored by a nursing specialist through the online platform RS while the control group (CG) received standard follow-up at the clinic. The Fibromyalgia Impact Questionnaire (FIQ) and 36-item Short-Form Health Survey (SF-36) were used at baseline, 6-month, and 12-month follow-up.

RESULTS

The IG showed a 65% improvement in the perception of their general state of health at 12 months into the study, compared with an improvement of 5.6% in the CG (p < .001). The IG also achieved better results for emotional status, with a maintained improvement throughout the study of more than 2 points in the anxiety variable (from 7.64 to 5.36), that remained constant in the CG. The depression variable also showed constant improvement over the 12 months of the study in the IG, rising from an average of 7.72 (standard deviation [SD] = 2.05) to 5.33 (SD = 1.65), while in the CG a slight deterioration was observed. In both cases, the difference in mood evolution was significant (p < .001).

CONCLUSIONS

Online nursing follow-up for people with fibromyalgia improves patients' perceived quality of life related to their welfare and emotional state. Fibromyalgia (FM) is among the diseases causing the highest rate of occupational disability in Spain. Fibromyalgia (FM) is a complex condition that causes pain, fatigue, non-refreshed sleep, mood disturbance and cognitive impairment.

Spanish Validation of the Self-Perceived Food Literacy Scale: A Five-Factor Model Proposition

Food literacy is a combination of functional, critical, and relational skills that pave the way for navigating the food system properly, taking personally and contextually available resources into account. The aim was to validate the Spanish version of the self-perceived food literacy scale in university students to explore the factorial structure of it and to correlate food literacy with other variables. The sample was composed of 362 Spanish university students (314 women). The full questionnaire was administered online and also assessed adherence to a Mediterranean diet, impulsivity, and health-related quality of life for convergent validity testing purposes. Confirmatory factor analysis was conducted to determine the factor structure of the food literacy scale. The Spanish version of the scale showed good indices of internal consistency (Cronbach's α = 0.894). Confirmatory factor analysis revealed a five-factor model that had a better fit index than the seven-factor model of the original scale. External validity was assessed by showing significant correlations with the rest of the variables. Therefore, the Spanish version of the scale is a reliable and valid measure of food literacy. It could be used to promote policies at Spanish universities to improve the food-related behaviors of students.

Efectos de un programa de judo utilitario adaptado sobre un adulto de 54 años. Estudio de caso

El envejecimiento activo de la población es uno de los principales retos a los que las administraciones deben responder. Dimensiones como la fragilidad y el miedo a caer, se asocian a limitaciones físicas, psicológicas y sociales de los adultos mayores. Se plantea el objetivo de conocer si la aplicación del programa JUA, aumenta la calidad de vida, al incidir positivamente en el miedo a caer y la percepción de salud, en base a la mejora su condición física y el control de las caídas. Se propone un estudio de caso dirigido a un sujeto varón de 54 años. Se analizó el miedo a caer, calidad de vida, percepción de salud y condición física del sujeto. Los resultados mostraron una mejoría en todas las dimensiones estudiadas. Concluimos que el programa JUA, aporta beneficios sobre el desempeño físico y psicológico en el sujeto de estudio.

A pilot randomized controlled trial of aquatic-based activities in a group occupational therapy program for adults living with serious mental illness in Spain

Although aquatic-based interventions are increasingly used in the psychiatric rehabilitation services, the effects of this type of community program as an adjuvant therapy for psychosocial problems of people with serious mental illness (SMI) have been under-explored. This research evaluated the feasibility and outcomes of an occupational therapy program consisting of aquatic-based activities (AA-OT program) in the community in Spain. This study is the first randomized controlled trial (RCT) on this topic. This pilot trial was conducted with a sample of 16 adults with SMI who were randomly allocated to the AA-OT program plus treatment as usual or treatment as usual alone (eight in each group). The AA-OT program included activation of daily living skills, warm-up, group activities/tasks, and relaxation. It consisted of two sessions per week over 12 weeks. Outcomes were evaluated at week 0 and 12. A total of 14 participants (87.5%) completed the trial. No adverse events or side-effects were noted. Comparisons between the two groups on change scores showed that participants in the intervention group showed significant improvements in several outcome measures: psychosocial problems (HoNOS), two health-related quality of life scales (SF-36: Physical Functioning and Mental Health), and performance of social activities (Activity and Social Relations scale). Satisfaction with the program was high. In conclusion, the results support the feasibility and potential benefits of this occupational therapy program. 12 weeks of aquatic-based activities in a group intervention may enhance the outcomes of psychiatric rehabilitation improving the severity of psychosocial problems, patient-reported health status, and social relations. This community-based program may be beneficial as a non-pharmacologic method in the illness management and recovery of people with SMI. The findings from this pilot trial need to be confirmed in a large, fully-powered RCT.

Relación entre calidad de vida, adherencia al tratamiento y nivel de conocimiento del paciente en hemodiálisis

Objetivo: Analizar la calidad de vida relacionada con la salud de los pacientes en tratamiento con hemodiálisis y su relación con su adherencia al tratamiento, comorbilidad y aspectos prácticos de autocuidado.Material y Método: Se ha llevado a cabo un estudio descriptivo, transversal, realizado en el Complexo Hospitalario de Ourense (España). Se incluyeron 51 pacientes en programa de hemodiálisis, con una edad media 64,96±13,03 años, y un tiempo en diálisis fue de 4,32±5,32 años. El 62,75% fueron hombres. Se analizó calidad de vida relacionada con la salud, comorbilidad, adherencia al tratamiento, nivel de conocimientos prácticos, además de variables sociodemográficas. Como instrumentos de medida: Índice comorbilidad de Charlson modificado, Test de Hermes, Kidney Disease Quality of Life-Short Form (KDQOL-SFTM). Se evaluaron conocimientos de autocuidado sobre cuidados generales, acceso vascular y dietéticos.Resultados: El índice de Comorbilidad medio fue de 4,42±2,83 puntos, y la adherencia al tratamiento, mediante el Test de Hermes de 2,78±0,84 puntos. En el análisis de regresión lineal, según modelo del componente físico, los valores del coeficiente Beta (β) asociado al sexo fueron β=0,304 (p=0,031) y a la comorbilidad de β=-0,436 (p=0,003). En el componente mental, coeficiente Beta (β) asociado al sexo β=0,330 (p=0,035) y la adherencia al tratamiento de β=0,311 (p=0,048) respectivamente.Conclusiones: El bajo nivel de conocimientos no se asocia a menor calidad de vida en la muestra estudiada. Los pacientes cumplidores obtienen mejores resultados en el componente mental estandarizado. A mayor comorbilidad menor calidad de vida.

Transcultural Validation of a Spanish Version of the Quality of Life in Epidermolysis Bullosa Questionnaire

INTRODUCTION

Epidermolysis bullosa (EB) is a relatively infrequent genodermatosis for which there is still no cure, and which impacts the quality of life of those that are affected by it. The Quality of Life evaluation in Epidermolysis Bullosa (QoLEB) questionnaire was specifically developed for English-speaking persons with EB.

OBJECTIVES

To undertake the transcultural adaptation and analysis of the psychometric properties of a Spanish version of the QoLEB questionnaire.

METHOD

We designed an observational study to implement the process of translation and validation of the scale in accordance with World Health Organisation guidelines. We assessed the content validity of the Spanish version with the participation of 33 adult patients who presented with four principal subtypes of EB. The subjects were examined and evaluated using the QoLEB and Short Form-36 (SF-36) questionnaires.

RESULTS

The Spanish version of the QoLEB displayed excellent internal consistency and content validity, α = 0.91. Test-retest reliability was likewise excellent (ps = 0.93), as was the reliability among subtypes (range ps = 0.82-0.93). The functional part of the QoLEB correlated well with the SF-36 physical component summary (ps = 0.70). The emotional QoLEB was moderately correlated with the SF-36 mental component summary (ps = 0.49). Significant discriminant validity existed between the global score of the questionnaire (p = 0.033) and the functional scale (p = 0.003).

CONCLUSIONS

The Spanish version of the QoLEB questionnaire can be recommended for use in any subsequent studies seeking to assess the efficacy of possible treatments and care programmes in this group.

A comparative study of treatment interventions for patellar tendinopathy: a secondary cost-effectiveness analysis

OBJECTIVE

To compare the cost-effectiveness of three patellar tendinopathy treatments.

DESIGN

Secondary (cost-effectiveness) analysis of a blinded, randomised controlled trial, with follow-up at 10 and 22 weeks.

SETTINGS

Recruitment was performed in sport clubs. The diagnosis and the intervention were carried out at San Jorge University.

PARTICIPANTS

The participants were adults between 18 and 45 years (n = 48) with patellar tendinopathy.

INTERVENTIONS

Participants received percutaneous needle electrolysis, dry needling or sham needling, all of which were combined with eccentric exercise.

MAIN OUTCOME MEASURES

Costs, quality-adjusted life years and incremental cost-effectiveness ratio were calculated for each group.

RESULTS

The total cost per session was similar in the three groups: €9.46 for the percutaneous needle electrolysis group; €9.44 for the dry needling group; and €8.96 for the sham group. The percutaneous needle electrolysis group presented better cost-effectiveness in terms of quality-adjusted life years and 96% and 93% probability of being cost-effective compared to the sham and dry needling groups, respectively.

CONCLUSION

Our study shows that percutaneous needle electrolysis has a greater probability of being cost-effective than sham or dry needling treatment.

Occupational health, frontline workers and COVID-19 lockdown: new gender-related inequalities?

INTRODUCTION

The abrupt onset of COVID-19, with its rapid spread, has had brutal consequences in all areas of society, including the workplace. In this paper, we report the working conditions, health, and tranquilisers and opioid analgesics use of workers during the first months of the ensuing pandemic, according to whether they were frontline workers or not and also according to sex.

METHODS

Our analysis is based on cross-sectional survey data (collected during April and May 2020) from the wage-earning population in Spain (n=15 070). We estimate prevalences, adjusted prevalence differences and adjusted prevalence ratios by sex and according to whether the worker is a frontline worker or not.

RESULTS

Employment and working conditions, exposure to psychosocial risks, as well as health status and the consumption of tranquilisers and opioid analgesics all showed sex and sectoral (frontline vs non-frontline) inequalities, which placed essential women workers in a particularly vulnerable position. Moreover, the consumption of tranquilisers and opioid analgesics increased during the pandemic and health worsened significantly among frontline women workers.

CONCLUSIONS

The exceptional situation caused by the COVID-19 pandemic provides an opportunity to revalue essential sectors and to dignify such employment and working conditions, especially among women. There is an urgent need to improve working conditions and reduce occupational risk, particularly among frontline workers. In addition, this study highlights the public health problem posed by tranquilisers and opioid analgesics consumption, especially among frontline women.