1
|
Argles IJS, Arrey S. How nurses can apply spiritual care to improve the daily lives of people with learning disabilities and their families. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:552-558. [PMID: 38900652 DOI: 10.12968/bjon.2023.0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
BACKGROUND Most UK nursing research into spirituality overlooks its daily application in certain specialties, notably learning disability nursing. AIMS Tz explore spirituality over the lifespans of people with learning disabilities and how spiritual care affects their quality of life. To provide practical examples for nurses on how to apply spiritual care in their daily practice. METHODS A literature review conducted between January 2002 and July 2022) following recommendations from the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Thomas and Harden's (2008) approach to thematic synthesis was used to structure 10 full-text articles into three key themes. FINDINGS The three key themes were: the role of the nurse, the impacts on the individual, and family/carer perspectives. CONCLUSION The nursing role in using spiritual care encompasses care planning an individual's spiritual activities, facilitating time alone, nurturing values such as self-acceptance, building therapeutic relationships, and advocating for progression in existing social structures and legislation.
Collapse
Affiliation(s)
| | - Sally Arrey
- Senior Lecturer, Department of Nursing and Midwifery, School of Human and Health Sciences, University of Huddersfield
| |
Collapse
|
2
|
Bovero A, Gottardo F, Tosi C, Pidinchedda A, Pesce S, Botto R, Caserta M, Ostacoli L, Rossini PG. Spiritual issues, beliefs, needs, and resources in palliative healthcare providers: An Italian qualitative study. J Health Psychol 2024:13591053241253046. [PMID: 38738922 DOI: 10.1177/13591053241253046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
The significance of spirituality in navigating the meaning of illness and death has been well-established. However, healthcare professionals working with palliation also grapple with their own spiritual dimensions when confronted with these circumstances. This study aimed to explore spirituality from a subjective standpoint among a sample of palliative care professionals, investigating its role and associated needs. For the first time, the FICA Spiritual History Tool was applied in a focus group setting. The meetings were transcribed, and thematic analysis was performed. The findings underscore how spirituality is perceived as more relational than transcendent, potentially fostering connections between the self, patients, and colleagues, thereby enhancing resilience. Simultaneously, spirituality needs to be considered as a potential source of suffering that could impact both the quality of life and work of healthcare workers involved. This issue should be addressed through dedicated moments of shared reprocessing, with beneficial implications for public health.
Collapse
Affiliation(s)
- Andrea Bovero
- Clinical Psychology and Psycho-Oncology Unit, Azienda Ospedaliera Universitaria (A.O.U.) "Cittá della Salute e della Scienza", Turin, Italy
| | - Francesco Gottardo
- Clinical Psychology and Psycho-Oncology Unit, Azienda Ospedaliera Universitaria (A.O.U.) "Cittá della Salute e della Scienza", Turin, Italy
| | - Chiara Tosi
- Clinical Psychology and Psycho-Oncology Unit, Azienda Ospedaliera Universitaria (A.O.U.) "Cittá della Salute e della Scienza", Turin, Italy
| | - Alexa Pidinchedda
- Clinical Psychology and Psycho-Oncology Unit, Azienda Ospedaliera Universitaria (A.O.U.) "Cittá della Salute e della Scienza", Turin, Italy
| | - Sara Pesce
- Clinical Psychology and Psycho-Oncology Unit, Azienda Ospedaliera Universitaria (A.O.U.) "Cittá della Salute e della Scienza", Turin, Italy
| | - Rossana Botto
- Clinical Psychology and Psycho-Oncology Unit, Azienda Ospedaliera Universitaria (A.O.U.) "Cittá della Salute e della Scienza", Turin, Italy
| | - Mario Caserta
- Clinical Psychology and Psycho-Oncology Unit, Azienda Ospedaliera Universitaria (A.O.U.) "Cittá della Salute e della Scienza", Turin, Italy
| | - Luca Ostacoli
- Clinical Psychology and Psycho-Oncology Unit, Azienda Ospedaliera Universitaria (A.O.U.) "Cittá della Salute e della Scienza", Turin, Italy
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | | |
Collapse
|
3
|
Baliga MS, Marakala V, Madathil LP, George T, D'souza RF, Palatty PL. Ethical and moral principles for oncology healthcare workers: A brief report from a Bioethics consortium emphasizing on need for education. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:145. [PMID: 38784285 PMCID: PMC11114567 DOI: 10.4103/jehp.jehp_1048_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/02/2023] [Indexed: 05/25/2024]
Abstract
The medical sub-specialty of Oncology presents diverse ethical dilemmas, often challenging cancer healthcare workers with difficult-to-handle clinical scenarios that are tough from a personal and professional perspective. Making decisions on patient care in various circumstances is a defining obligation of an oncologist and those duty-based judgments entail more than just selecting the best treatment or solution. Ethics is an essential and inseparable aspect of clinical medicine and the oncologists as well as the allied health care workers are ethically committed to helping the patient, avoiding or minimizing harm, and respecting the patient's values and choices. This review provides an overview of ethics and clinical ethics and the four main ethical principles of autonomy, beneficence, non-maleficence, and justice are stated and explained. At times there are frequently contradictions between ethical principles in patient care scenarios, especially between beneficence and autonomy. In addition, truth-telling, professionalism, empathy, and cultural competence; which are recently considered important in cancer care, are also addressed from an Indian perspective.
Collapse
Affiliation(s)
- Manjeshwar S. Baliga
- Department of Education, International Program, International Chair in Bioethics, World Medical Association Cooperating Centre (Formerly UNESCO Chair in Bioethics University of Haifa), Melbourne, Australia
- The Bioethics SAARC Nodal Centre, International Network Bioethics, Amrita Institute of Medical Sciences, Kochi, Ernakulam, Kerala, India
- Bioethics Education and Research Unit, Mangalore Institute of Oncology, Pumpwell, Mangalore, Karnataka, India
| | - Vijaya Marakala
- Department of Biochemistry, College of Medicine and Health Sciences, National University of Science and Technology, Sohar, Oman
| | - Lal P. Madathil
- Department of Education, International Program, International Chair in Bioethics, World Medical Association Cooperating Centre (Formerly UNESCO Chair in Bioethics University of Haifa), Melbourne, Australia
- The Bioethics SAARC Nodal Centre, International Network Bioethics, Amrita Institute of Medical Sciences, Kochi, Ernakulam, Kerala, India
| | - Thomas George
- Internal Medicine, Coney Island Hospital, 2601 Ocean Pkwy, Brooklyn, New York, USA
| | - Russell F. D'souza
- Department of Education, International Program, International Chair in Bioethics, World Medical Association Cooperating Centre (Formerly UNESCO Chair in Bioethics University of Haifa), Melbourne, Australia
| | - Princy L. Palatty
- The Bioethics SAARC Nodal Centre, International Network Bioethics, Amrita Institute of Medical Sciences, Kochi, Ernakulam, Kerala, India
- Department of Pharmacology, Amrita School of Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Ernakulam, Kerala, India
| |
Collapse
|
4
|
Nowicki GJ, Schneider-Matyka D, Godlewska I, Tytuła A, Kotus M, Walec M, Grochans E, Ślusarska B. The relationship between the strength of religious faith and spirituality in relation to post-traumatic growth among nurses caring for COVID-19 patients in eastern Poland: a cross-sectional study. Front Psychiatry 2024; 14:1331033. [PMID: 38260777 PMCID: PMC10800582 DOI: 10.3389/fpsyt.2023.1331033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction The COVID-19 pandemic had forced intensive care unit (ICU) nurses to adapt to extreme conditions in a short period of time. This resulted in them experiencing extremely stressful situations. The aim of this study was to assess the relationship between post-traumatic growth (PTG) and religiosity and spirituality (R/S) among nurses caring for COVID-19 patients in intensive care during the pandemic. Materials and methods 120 nurses working in Lublin, eastern Poland, participated in the cross-sectional study. The questionnaire was made up of three standardised tools: The Post-Traumatic Growth Inventory, The Santa Clara Strength of Religious Faith Questionnaire, The Spiritual Attitude and Involvement List. Results In terms of spirituality, the study group of nurses achieved the highest score in the Connectedness with Nature subscale (4.37 ± 1.07), while the strength of religious beliefs had a positive correlation with post-traumatic growth only in the Spiritual changes subscale (r = 0.422, p < 0.001). The following dimensions of spirituality were significantly correlated with post-traumatic growth in the multi-factor model that included religiosity and spirituality: Transcendent experiences, Spiritual activities, Meaningfulness, Acceptance, and Trust. We saw that increase in the assessment of the Transcendent experiences, Meaningfulness and Trust subscales significantly mirrors increase in post-traumatic growth, while increase in the assessment of the Spiritual activities and Acceptance subscales significantly mirrors decrease in post-traumatic growth. The above variables explained up to 44% of the dependent variable. Conclusion Both religiosity and spirituality were significantly associated with post-traumatic growth in the group of ICU nurses, but spirituality appears to have played a larger role. Our findings support the value and significance of the development of spiritual and religious identity as a means of enhancing positive psychological changes in the face of traumatic events.
Collapse
Affiliation(s)
- Grzegorz Józef Nowicki
- Department of Family and Geriatric Nursing, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Daria Schneider-Matyka
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Iwona Godlewska
- Second Department of Anaesthesia and Intensive Therapy, Medical University of Lublin, Lublin, Poland
| | - Andrzej Tytuła
- Head Chamber of Nurses and Midwives, Warszawa, Poland
- Faculty of Human Sciences, University of Economics and Innovation, Lublin, Poland
| | - Marzena Kotus
- Department of Anaesthesiological and Intensive Care Nursing, Medical University of Lublin, Lublin, Poland
| | - Monika Walec
- Department of Family and Geriatric Nursing, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Elżbieta Grochans
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Barbara Ślusarska
- Department of Family and Geriatric Nursing, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| |
Collapse
|
5
|
Kubitza J, Große G, Schütte-Nütgen K, Frick E. Influence of spirituality on moral distress and resilience in critical care staff: A scoping review. Intensive Crit Care Nurs 2023; 76:103377. [PMID: 36669436 PMCID: PMC9850638 DOI: 10.1016/j.iccn.2022.103377] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/06/2022] [Accepted: 12/10/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The Covid 19 pandemic has created a situation in which critical care staff experience moral distress. For reducing moral distress, resources such as spirituality can be used. The aim of this scoping review is to explore whether spirituality mitigates the moral distress of critical care staff and strengthens their resilience. The spiritual resources will be identified and the ability of the staff to use spiritual resources will be explored. METHODOLOGY A scoping review of studies reporting on the association between spirituality, moral distress, and resilience. Qualitative and quantitative studies from 2020 that examined critical care staff are included. This scoping review used the five-step framework proposed by Arksey and O'Malley and was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework for scoping reviews. The literature searches were conducted in 12 databases. RESULTS 13 studies met inclusion criteria. Critical care staff declaring themselves as spiritual have a higher risk of moral distress and are often not able to use spiritual resources on their own. For effective use of spiritual resources to reduce moral distress, staff need to be skilled in the practice of spirituality with the aim to find inner peace, focus on the positive, and regain a sense of purpose in the work. CONCLUSION Spirituality does not automatically help the critical care staff to cope with moral distress and strengthen resilience. Institutions need to create conditions in which the critical care staff are supported to use their spiritual resources. IMPLICATION FOR CLINICAL PRACTICE Institutions need to involve staff more in the design, implementation, and delivery of spiritual interventions to minimise moral distress. Further research is necessary to examine the impact of critical care staff's demographic characteristics on their spirituality, moral distress, and resilience.
Collapse
Affiliation(s)
- Jenny Kubitza
- University Hospital rechts der Isar, Department of Psychosomatic Medicine and Psychotherapy, Professorship of Spiritual Care and Psychosomatic Health, Technical University of Munich, Kaulbachstraße 22a, Munich 80539, Germany,Corresponding author
| | - Greta Große
- Ludwig-Maximilians-Universität München, Faculty of Medicine, Munich, Germany
| | - Katharina Schütte-Nütgen
- University Medical Center Freiburg, Clinic of Palliative Medicine, Robert-Koch-Straße 3, Freiburg 79106, Germany
| | - Eckhard Frick
- University Hospital rechts der Isar, Department of Psychosomatic Medicine and Psychotherapy, Professorship of Spiritual Care and Psychosomatic Health, Technical University of Munich, Kaulbachstraße 22a, Munich 80539, Germany
| |
Collapse
|
6
|
Miller M, Addicott K, Rosa WE. Spiritual Care as a Core Component of Palliative Nursing. Am J Nurs 2023; 123:54-59. [PMID: 36698364 PMCID: PMC9983559 DOI: 10.1097/01.naj.0000919748.95749.e5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
ABSTRACT Spirituality is one aspect of the human experience that is unique to each person and may become especially important in the face of life-threatening illness. While evidence supports the need to address spirituality as part of holistic palliative care nursing, it is hoped that "spiritual care" will not become another item on nurses' to-do list, but rather will be part of nurses' everyday lives and nursing practice. Taking time to assess personal needs, and consciously connecting to meaning, hope, and peace, can support nurses' return to the deeper roots of nursing. Addressing spirituality as part of palliative nursing care can also acknowledge the complex and multidimensional experiences of the patients that nurses serve. Connecting, or reconnecting, with nurses' unique sense of spirituality can serve as a powerful resource for resilience. This article highlights the relevance of spiritual care to palliative nursing and offers practical tips to incorporate spiritual care into everyday nursing practice.
Collapse
Affiliation(s)
- Megan Miller
- Megan Miller is an assistant professor at the University of Wisconsin-Madison School of Nursing. Katie Addicott is a palliative care NP at Maine Medical Center, Portland. William E. Rosa is an assistant attending behavioral scientist at Memorial Sloan Kettering Cancer Center, New York City. Contact author: Megan Miller, . The authors have disclosed no potential conflicts of interest, financial or otherwise
| | | | | |
Collapse
|
7
|
Hinzmann D, Schütte-Nütgen K, Büssing A, Boenisch O, Busch HJ, Dodt C, Friederich P, Kochanek M, Michels G, Frick E. Critical Care Providers' Moral Distress: Frequency, Burden, and Potential Resources. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:333. [PMID: 36612657 PMCID: PMC9819312 DOI: 10.3390/ijerph20010333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 10/25/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Critical Care Providers (CCPs) experience situations that challenge their ethics and professional standards and may entail moral distress (MD). AIM To analyze MD perceived by CCPs in intensive care units (ICUs) or emergency departments (EDs) and further clarify whether CCPs who rely on spiritual resources differ in their perception of MD from those who do not utilize these resources. METHODS A cross-sectional anonymous survey was administered using a modified version of the German language version of the Moral Distress Scale (MDS) with 2 × 12 items to assess the frequency and the respective perceived burden of specific situations by applying a 5-point Likert scale. Explorative factor analysis was performed and the sub-constructs of the respective items regarding MD frequency and burden were identified. Job burden and professional satisfaction were measured using visual analogue scales (VAS) and a four-point Likert scale, respectively. The 15-item SpREUK questionnaire was applied to measure spiritual attitudes and behaviours and to differentiate between religious and spiritual persons. Data from 385 German-speaking CCPs were included (55% physicians, 45% nurses). RESULTS Conflict situations are similar for physicians and nurses although they are perceived as more burdensome by nurses. Among physicians, the MDS factor Looking away/Resignation scores highest for assistant physician residents, whereas distress caused by looking away is more often perceived by specialist physicians without a managerial position. Work satisfaction is inversely associated with MD and emotional exhaustion is positively associated with it. Participants' spirituality is marginally associated with MD. The best predictors of both MD frequency and burden are emotional exhaustion with further influences of work satisfaction, being a nurse, and being a non-believer on the frequency of MD perception. Being a nurse, participants' experience in ICU/ED, and being of the male gender are further predictors of MD burden. CONCLUSIONS MD is experienced differently by different groups of CCPs depending on their place in the hierarchy of responsibility. As MD perception is best predicted by emotional exhaustion, these situations should be avoided. Although some CCPs may rely on spiritual resources, all need individual and team support to cope with MD.
Collapse
Affiliation(s)
- Dominik Hinzmann
- Department of Anaesthesiology and Intensive Care, University Hospital Rechts der Isar, 81675 Munich, Germany
- School of Medicine, Technical University of Munich, 80333 München, Germany
| | | | - Arndt Büssing
- Quality of Life, Spirituality and Coping, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
| | - Olaf Boenisch
- Department of Intensive Care, University Hospital Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Hans-Jörg Busch
- Department of Emergency Medicine, University Hospital Freiburg, 79106 Freiburg, Germany
| | - Christoph Dodt
- Emergency Department, München Klinik, 81925 Munich, Germany
| | | | - Matthias Kochanek
- Department of Intensive Care, University Hospital Cologne, 50937 Cologne, Germany
| | - Guido Michels
- Emergency Department, Sankt Antonius Hospital, 52249 Eschweiler, Germany
| | - Eckhard Frick
- School of Medicine, Technical University of Munich, 80333 München, Germany
- Spiritual Care and Psychosomatic Health, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, 80539 Munich, Germany
| |
Collapse
|
8
|
Cooke S, Booth R, Jackson K. Moral distress in critical care nursing practice: A concept analysis. Nurs Forum 2022; 57:1478-1483. [PMID: 35962765 DOI: 10.1111/nuf.12786] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 07/17/2022] [Accepted: 08/01/2022] [Indexed: 11/28/2022]
Abstract
AIM To provide a critical analysis of the concept of moral distress (MD) in critical care (CC) nursing. BACKGROUND Despite extensive inquiry pertaining to the legitimacy of MD within nursing discourse, some authors still question its relevancy to the profession. However, amid the global COVID-19 pandemic, MD is generating a significant amount of discussion anew, warranting the further exploration of the concept within CC nursing to provide clarity and expand on the definition. DESIGN Rodger's Evolutionary Concept Analysis method was used to guide this analysis. METHODS Related terms, attributes, antecedents, and consequences of MD were identified using current literature. RESULTS The results of this analysis demonstrate strong congruence between the attributes, antecedents, and negative consequences pertaining to MD. However, a new theme has emerged from this review of the contemporary literature, highlighting the potential unexpected positive outcomes perceived by nurses who experience MD, including the provision of better care, increased levels of empathy, and enhanced opportunities for ethical reflection.
Collapse
Affiliation(s)
- Samantha Cooke
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
| | - Richard Booth
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
| | - Kimberley Jackson
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
| |
Collapse
|
9
|
Futile care and burnout in intensive care unit nurses. Intensive Crit Care Nurs 2022; 71:103228. [DOI: 10.1016/j.iccn.2022.103228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
10
|
Echeverria I, Peraire M, Penadés D, Quintero V, Benito A, Almodóvar I, Haro G. Purpose in Life and Character Strengths as Predictors of Health Sciences Students' Psychopathology During the COVID-19 Pandemic. Front Psychiatry 2022; 13:932249. [PMID: 35865306 PMCID: PMC9294443 DOI: 10.3389/fpsyt.2022.932249] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/06/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Health sciences students experience high levels of psychopathology conditioned by psychosocial, financial, and academic factors. However, COVID-19 pandemic might even have worsened their mental health. Thus, this article aims to evaluate how the exposure to COVID-19 pandemic has affected these students' mental health and to determine the effect of purpose in life and character strengths on this psychopathology. METHODS A cross-sectional study of unpaired samples was carried out in Spain during the first and third waves of the pandemic in 70 medical and 52 nursing students. RESULTS The risk factor that most determined the appearance of anxiety was the exposure of family and friends to COVID-19 (OR = 4.01; p < 0.001), while the most protective factors were honesty (OR = -1.14; p = 0.025) and purpose in life (OR = -0.18; p < 0.001). Purpose in life also protected against the onset of depression and total psychopathology. In addition, we observed studying medicine was a protective factor against total psychopathology while being a nursing student was associated with high levels of acute stress. CONCLUSION Exposure of the students' family and friends to SARS-CoV-2 favored the appearance of symptoms of anxiety. Honesty had a preventing role in the onset of anxiety and a high purpose in life was protective against the appearance of anxiety, depression, and total psychopathology.
Collapse
Affiliation(s)
- Iván Echeverria
- TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, Castelló de la Plana, Spain.,Department of Mental Health, Consorci Hospitalari Provincial de Castelló, Castelló de la Plana, Spain
| | - Marc Peraire
- TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, Castelló de la Plana, Spain.,Department of Mental Health, Consorci Hospitalari Provincial de Castelló, Castelló de la Plana, Spain
| | - Danaide Penadés
- Faculty of Health Sciences, Universidad Cardenal Herrera-CEU, CEU Universities, Castelló de la Plana, Spain
| | - Valentina Quintero
- Faculty of Health Sciences, Universidad Cardenal Herrera-CEU, CEU Universities, Castelló de la Plana, Spain
| | - Ana Benito
- TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, Castelló de la Plana, Spain.,Torrente Mental Health Unit, Hospital General de Valencia, Valencia, Spain
| | - Isabel Almodóvar
- TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, Castelló de la Plana, Spain.,Department of Mental Health, Consorci Hospitalari Provincial de Castelló, Castelló de la Plana, Spain
| | - Gonzalo Haro
- TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, Castelló de la Plana, Spain.,Department of Mental Health, Consorci Hospitalari Provincial de Castelló, Castelló de la Plana, Spain
| |
Collapse
|