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Zhang H, Zhang X, Jiang X, Dai R, Zhao N, Pan W, Guo J, Fan J, Bao S. Mindfulness-based intervention for hypertension patients with depression and/or anxiety in the community: a randomized controlled trial. Trials 2024; 25:299. [PMID: 38698436 DOI: 10.1186/s13063-024-08139-0] [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] [Received: 09/28/2023] [Accepted: 04/25/2024] [Indexed: 05/05/2024] Open
Abstract
OBJECTIVE To evaluate mindfulness-based intervention for hypertension with depression and/or anxiety. METHODS 10-week mindfulness-based intervention, including health education for hypertension, exclusively for the control group, was administered to the intervention group to assist sixty hypertension patients with depression/anxiety. Among them, the intervention group comprised 8 men and 22 women, with a mean age of 60.02 years and a mean duration of hypertension of 6.29 years. The control group consisted of 14 men and 16 women with a mean age of 57.68 years and a mean duration of hypertension of 6.32 years. The severity of depressive and/or anxiety symptoms was assessed using the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item Generalized Anxiety Disorder scale (GAD-7), along with blood pressure (BP) measurements taken twice daily. The study utilized a self-made self-efficacy scale and awareness of physical and mental health to evaluate mental health and state. RESULTS The depression PHQ-9 or GAD-7 scores reduced by 21.1% or 17.8% in the mindfulness-based intervention group, compared to the control (Z = -2.040, P = 0.041) post 10-week period, suggesting significant reduction in anxiety/stress. These results were consistent with a reduction in systolic BP of 12.24 mm Hg (t = 6.041, P = 0.000). The self-efficacy score of the mindfulness intervention group significantly improved compared to the control (t = 7.818, P < 0.001), while the awareness of physical and mental health in the mindfulness intervention group significantly improved compared to the control (χ2 = 5.781, P = 0.016). CONCLUSION Mindfulness-based, short-term focused interventions provide modest relief for depression and/or anxiety and are effective in lowering blood pressure and improving self-efficacy scores. TRIAL REGISTRATION Chinese Clinical Trial Registry, ChiCTR1900028258. Registered 16 December 2019, https://www.chictr.org.cn/showproj.html?proj=43627 .
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Affiliation(s)
- Hailiang Zhang
- Center for Laboratory and Simulation Training, School of Public Health, Center for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, 730101, Gansu, China
- Collaborative Innovation Center for Traditional Chinese Medicine Prevention and, Control of Environmental and Nutrition-Related Diseases in Northwest China, Lanzhou, 730101, Gansu, China
- Department of Mental Health, Gansu Provincial Centre for Disease Control and Prevention, Lanzhou, 730030, Gansu, China
| | - Xiangrong Zhang
- Department of Chinese Medicine, Center of Hekou Town, Xigu District, Lanzhou, 730094, Gansu, China
| | - Xiaomei Jiang
- Department of Psychosomatic and Sleep Medicine, Gansu Gem Flower Hospital, Xigu District, Lanzhou, 730060, Gansu, China
| | - Runjing Dai
- Center for Laboratory and Simulation Training, School of Public Health, Center for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, 730101, Gansu, China
| | - Na Zhao
- Department of Hospital Infection-Control, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, 730020, Gansu, China
| | - Weimin Pan
- Department of Mental Health, Gansu Provincial Centre for Disease Control and Prevention, Lanzhou, 730030, Gansu, China
| | - Jiaohong Guo
- Department of Vasculo-Cardiology, Pingliang Second People's Hospital, Kongtong District, Pingliang, 744000, Gansu, China.
| | - Jingchun Fan
- Center for Laboratory and Simulation Training, School of Public Health, Center for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, 730101, Gansu, China.
- Collaborative Innovation Center for Traditional Chinese Medicine Prevention and, Control of Environmental and Nutrition-Related Diseases in Northwest China, Lanzhou, 730101, Gansu, China.
| | - Shisan Bao
- Center for Laboratory and Simulation Training, School of Public Health, Center for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, 730101, Gansu, China.
- Collaborative Innovation Center for Traditional Chinese Medicine Prevention and, Control of Environmental and Nutrition-Related Diseases in Northwest China, Lanzhou, 730101, Gansu, China.
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Gamonal B, Quispe-Lizano R, Javier-Murillo N, Lapeyre-Rivera A, Perea-Flórez F, Velásquez-Rimachi V, Alva-Diaz C, Velazco-Gonzales G, Ahmed O, Chung S. Comparison of the Stress and Anxiety to Viral Epidemic-9 and SAVE-6 scales among healthcare workers in Peru. Front Psychiatry 2024; 15:1352896. [PMID: 38751417 PMCID: PMC11094251 DOI: 10.3389/fpsyt.2024.1352896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 03/29/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction Peru is a country that has a high incidence of viral outbreaks and epidemics, which is why it is necessary to validate a scale that measures anxiety and stress in professionals who are on the front lines of these events. Therefore, our objective was to validate the Peruvian-Spanish version of the Stress and Anxiety to Viral Epidemics-9 items (SAVE-9) scale and to concurrently compare its validity and internal consistency with the SAVE-6 scale among healthcare workers (HCWs). Materials and methods We conducted a cross-sectional study based on data collected from a self-reported survey in paper-and-pencil format between April and July 2023. A total of 203 HCWs participated in the research. We developed a confirmatory factor analysis (CFA) and item response theory (IRT). We calculated Cronbach's α coefficient and McDonald's ω to assess the internal consistency of the scales. Results The results show that SAVE-9 (a two-factor model) and SAVE-6 (a one-factor model) provided an excellent fit in the confirmatory factor analysis. Both scales demonstrated strong internal consistency (Cronbach's α 0.85 and 0.86, respectively). Significant correlations were found between the SAVE-9 and SAVE-6 scales and Generalized Anxiety Disorder-7 items scale (r = 0.44 and r = 0.38, respectively, p < 0.001) as well as the Patient Health Questionnaire-9 items (r = 0.39 and r = 0.35, respectively, p < 0.001). The optimal cutoff points for SAVE-9 and SAVE-6 were identified for assessing anxiety, aligned with a GAD-7 score ≥5 points. Conclusion The Peruvian-Spanish SAVE-9 and SAVE-6 scales are reliable and valid rating scales to assess the anxiety response of HCWs in response to viral epidemics. Though COVID-19 is diminished, these scales will be useful for other viral epidemics in the future.
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Affiliation(s)
- Bryan Gamonal
- Facultad de Medicina Humana, Universidad de Piura, Lima, Peru
| | | | - Nair Javier-Murillo
- Facultad de Medicina Humana, Universidad de Piura, Lima, Peru
- Departamento de Investigación, Red de Eficacia Clínica y Sanitaria, (REDECS), Lima, Peru
| | - André Lapeyre-Rivera
- Departamento de Investigación, Red de Eficacia Clínica y Sanitaria, (REDECS), Lima, Peru
- Sociedad Científica de San Fernando, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Francisco Perea-Flórez
- Facultad de Medicina Humana, Universidad de Piura, Lima, Peru
- Departamento de Investigación, Red de Eficacia Clínica y Sanitaria, (REDECS), Lima, Peru
| | - Víctor Velásquez-Rimachi
- Grupo de Investigación Neurociencia, Efectividad Clínica y Salud Pública (NEURONECS), Universidad Científica del Sur, Lima, Peru
| | - Carlos Alva-Diaz
- Grupo de Investigación Neurociencia, Efectividad Clínica y Salud Pública (NEURONECS), Universidad Científica del Sur, Lima, Peru
- Servicio de Neurología, Departamento de Medicina y Oficina de Apoyo a la Docencia e Investigación (OADI), Hospital Daniel Alcides Carrión, Callao, Peru
| | | | - Oli Ahmed
- Department of Psychology, University of Chittagong, Chattogram, Bangladesh
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Adler DA, Stamatis CA, Meyerhoff J, Mohr DC, Wang F, Aranovich GJ, Sen S, Choudhury T. Measuring algorithmic bias to analyze the reliability of AI tools that predict depression risk using smartphone sensed-behavioral data. NPJ MENTAL HEALTH RESEARCH 2024; 3:17. [PMID: 38649446 PMCID: PMC11035598 DOI: 10.1038/s44184-024-00057-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 02/07/2024] [Indexed: 04/25/2024]
Abstract
AI tools intend to transform mental healthcare by providing remote estimates of depression risk using behavioral data collected by sensors embedded in smartphones. While these tools accurately predict elevated depression symptoms in small, homogenous populations, recent studies show that these tools are less accurate in larger, more diverse populations. In this work, we show that accuracy is reduced because sensed-behaviors are unreliable predictors of depression across individuals: sensed-behaviors that predict depression risk are inconsistent across demographic and socioeconomic subgroups. We first identified subgroups where a developed AI tool underperformed by measuring algorithmic bias, where subgroups with depression were incorrectly predicted to be at lower risk than healthier subgroups. We then found inconsistencies between sensed-behaviors predictive of depression across these subgroups. Our findings suggest that researchers developing AI tools predicting mental health from sensed-behaviors should think critically about the generalizability of these tools, and consider tailored solutions for targeted populations.
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Affiliation(s)
- Daniel A Adler
- Cornell Tech, Information Science, 2 W Loop Rd, New York, NY, 10044, USA.
| | - Caitlin A Stamatis
- Northwestern University Feinberg School of Medicine, Center for Behavioral Intervention Technologies, Chicago, IL, 60611, USA
| | - Jonah Meyerhoff
- Northwestern University Feinberg School of Medicine, Center for Behavioral Intervention Technologies, Chicago, IL, 60611, USA
| | - David C Mohr
- Northwestern University Feinberg School of Medicine, Center for Behavioral Intervention Technologies, Chicago, IL, 60611, USA
| | - Fei Wang
- Weill Cornell Medicine, Population Health Sciences, New York, NY, 10065, USA
| | | | - Srijan Sen
- Michigan Medicine, Department of Psychiatry, Ann Arbor, MI, 48109, USA
| | - Tanzeem Choudhury
- Cornell Tech, Information Science, 2 W Loop Rd, New York, NY, 10044, USA
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Adler DA, Stamatis CA, Meyerhoff J, Mohr DC, Wang F, Aranovich GJ, Sen S, Choudhury T. Measuring algorithmic bias to analyze the reliability of AI tools that predict depression risk using smartphone sensed-behavioral data. RESEARCH SQUARE 2024:rs.3.rs-3044613. [PMID: 38746448 PMCID: PMC11092819 DOI: 10.21203/rs.3.rs-3044613/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
AI tools intend to transform mental healthcare by providing remote estimates of depression risk using behavioral data collected by sensors embedded in smartphones. While these tools accurately predict elevated symptoms in small, homogenous populations, recent studies show that these tools are less accurate in larger, more diverse populations. In this work, we show that accuracy is reduced because sensed-behaviors are unreliable predictors of depression across individuals; specifically the sensed-behaviors that predict depression risk are inconsistent across demographic and socioeconomic subgroups. We first identified subgroups where a developed AI tool underperformed by measuring algorithmic bias, where subgroups with depression were incorrectly predicted to be at lower risk than healthier subgroups. We then found inconsistencies between sensed-behaviors predictive of depression across these subgroups. Our findings suggest that researchers developing AI tools predicting mental health from behavior should think critically about the generalizability of these tools, and consider tailored solutions for targeted populations.
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Leon-Zamora S, Villarreal-Zegarra D, Bellido-Boza L. Association between abdominal obesity and depressive symptoms in Peruvian women aged 18-49 years: a sub-analysis of the Demographic and Family Health Survey 2018-2019. Public Health Nutr 2024; 27:e114. [PMID: 38605643 PMCID: PMC11036433 DOI: 10.1017/s1368980024000867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 02/22/2024] [Accepted: 04/02/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVE Abdominal obesity (AO) is characterised by excess adipose tissue. It is a metabolic risk that affects the physical and mental health, particularly in women since they are more prone to mental health problems like depression. This study investigated the association between AO and depressive symptoms in Peruvian women of reproductive age (18-49 years). DESIGN This is a cross-sectional observational study. SETTING Peruvian women population of reproductive age. PARTICIPANTS We used data from the Peruvian Demographic and Family Health Survey (DHS) for 2018 and 2019 to assess 17 067 women for the presence of depressive symptoms (using the Patient Health Questionnaire (PHQ-9): cut-off score ≥ 10) and AO (measured by abdominal circumference; cut-off score ≥88 cm). RESULTS We observed a 64·55 % prevalence of AO and 7·61 % of depressive symptoms in the study sample. Furthermore, 8·23 % of women with AO had depressive symptoms (P < 0·05). Initially, women with AO appeared to have a 26 % higher risk of depressive symptoms compared with women without AO (P = 0·028); however, after adjustment for covariates, no statistically significant association was observed. CONCLUSIONS Therefore, although both conditions are common in women of this age group, no significant association was found between AO and depressive symptoms.
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Affiliation(s)
- Sharon Leon-Zamora
- Facultad de Ciencias de la Salud, Universidad Peruana de
Ciencias Aplicadas, Lima, Peru
| | - David Villarreal-Zegarra
- Instituto Peruano de Orientación Psicológica, Lima,
Peru
- Escuela de Psicología, Universidad Continental,
Lima, Peru
| | - Luciana Bellido-Boza
- Facultad de Ciencias de la Salud, Universidad Peruana de
Ciencias Aplicadas, Lima, Peru
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Villarreal-Zegarra D, Paredes-Angeles R, Mayo-Puchoc N, Arenas-Minaya E, Huarcaya-Victoria J, Copez-Lonzoy A. Psychometric properties of the GAD-7 (General Anxiety Disorder-7): a cross-sectional study of the Peruvian general population. BMC Psychol 2024; 12:183. [PMID: 38566138 PMCID: PMC10985987 DOI: 10.1186/s40359-024-01688-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/26/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Anxiety disorders are among the main mental health problems worldwide and are considered one of the most disabling conditions. Therefore, it is essential to have measurement tools that can be used to screen for anxiety symptoms in the general population and thus identify potential cases of people with anxiety symptoms and provide them with timely care. Our aim was to evaluate the psychometric properties of the General Anxiety Disorder-7 scale (GAD-7) in the Peruvian population. METHOD Our study was a cross-sectional study. The sample included people aged 12 to 65 years in Peru. Confirmatory factor analysis, analysis of measurement invariance, convergent validity with the Patient Health Questionnaire-9 (PHQ-9) and internal consistency analysis were performed. RESULTS In total, 4431 participants were included. The one-factor model showed the best fit (CFI = 0.994; TLI = 0.991; RMSEA = 0.068; WRMR = 1.567). The GAD-7 score showed measurement invariance between men and women and between age groups (adults vs. adolescents) (ΔCFI < 0.01). The internal consistency of the one-factor model was satisfactory (ω = 0.90, α = 0.93). The relationship between depressive symptoms (PHQ-9) and anxiety symptoms (GAD-7) presented a moderate correlation (r = 0.77). CONCLUSIONS Our study concluded that the GAD-7 score shows evidence of validity and reliability for the one-factor model. Furthermore, because the GAD-7 score is invariant, comparisons can be made between groups (i.e., by sex and age group). Finally, we recommend the use of the GAD-7 for the general population in the Peruvian context.
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Affiliation(s)
- David Villarreal-Zegarra
- Universidad César Vallejo, Escuela de Medicina, Trujillo, Peru
- Instituto Peruano de Orientación Psicológica, Lima, Peru
| | | | | | | | - Jeff Huarcaya-Victoria
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Filial Ica, Ica, Peru
| | - Anthony Copez-Lonzoy
- Universidad San Ignacio de Loyola, Lima, Peru.
- Instituto Peruano de Orientación Psicológica, Lima, Peru.
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7
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Illachura VC, Montesinos-Malpartida MI, Bellido-Boza L, Puyén ZM, Blitchtein-Winicki D. Physical punishment and effective verbal communication in children aged 9-36 months, according to sex: secondary analysis of a national survey. BMC Pediatr 2024; 24:134. [PMID: 38378501 PMCID: PMC10877749 DOI: 10.1186/s12887-024-04606-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/30/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND A substantial number of children in the world are regularly subjected to physical punishment by their parents as a method of upbringing. Evidence suggests that it has negative effects on the development of brain function. However, evidence regarding its association with verbal communication is limited and heterogeneous. It is also unknown whether the effects are the same in both boys and girls; especially in the contexts of developing countries, where the highest rates of physical punishment are found. OBJECTIVE This investigation aimed at analyzing the association between physical punishment administered by both fathers and mothers and effective verbal communication among children aged 9-36 months according to sex. METHODS A secondary analytical cross-sectional study was conducted based on the 2018-2019 Peruvian Demographic and Family Health Survey. Physical punishment, based on the mother's report of the use of hitting and/or slapping, was considered as a method to correct children by the father and/or mother. Effective verbal communication (EVC) was measured using the Battle scale which consists of age-appropriate questions included in the early childhood development module. A generalized linear model of the family and Log Poisson link option was used to identify the association between them, using the crude, general adjusted, and sex-stratified models. RESULTS Of all the children, 16.31% received physical punishment from their father and/or mother, wherein 16.65% were boys and 15.97% were girls. Moreover, 36.48% exhibited EVC, wherein 32.55% were boys and 40.50% were girls. Adjusting for socioeconomic level, witnessing violence, mother's marital status, age, occupation, education level, language, number of children, and moderate-to-severe depressive symptoms, it was found that boys who received physical punishment from their father and/or mother have a 31% lower probability of EVC (adjusted prevalence ratio (aPR) 0.69, 95% confidence interval (CI) 0.58-0.83, p < 0.001), whereas no association was found in girls who received physical punishment from their father and/or mother and EVC (aPR 0.93, 95% CI 0.81-1.06, p = 0.278). CONCLUSIONS An association was found between physical punishment administered by father and/or mother and reduced EVC among boys, whereas no such association was found among girls. It is possible that even though a significant impact has not been observed in girls during this early stage, they may experience consequences in later stages of life, further research is needed.
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Affiliation(s)
- Vanessa Chire Illachura
- Facultad de Ciencias de La Salud, Universidad Peruana de Ciencias Aplicadas, Av. Alameda San Marcos 11, Chorrillos, 15067, Lima, Perú
| | - Maria Inés Montesinos-Malpartida
- Facultad de Ciencias de La Salud, Universidad Peruana de Ciencias Aplicadas, Av. Alameda San Marcos 11, Chorrillos, 15067, Lima, Perú
| | - Luciana Bellido-Boza
- Facultad de Ciencias de La Salud, Universidad Peruana de Ciencias Aplicadas, Av. Alameda San Marcos 11, Chorrillos, 15067, Lima, Perú
| | - Zully M Puyén
- Facultad de Ciencias de La Salud, Universidad Peruana de Ciencias Aplicadas, Av. Alameda San Marcos 11, Chorrillos, 15067, Lima, Perú
| | - Dora Blitchtein-Winicki
- Facultad de Ciencias de La Salud, Universidad Peruana de Ciencias Aplicadas, Av. Alameda San Marcos 11, Chorrillos, 15067, Lima, Perú.
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Valladares-Garrido D, Zila-Velasque JP, Santander-Hernández FM, Guevara-Morales MA, Morocho-Alburqueque N, Failoc-Rojas VE, Pereira-Victorio CJ, Vera-Ponce VJ, León-Figueroa DA, Valladares-Garrido MJ. Association between love breakup and suicidal ideation in Peruvian medical students: a cross-sectional study during the COVID-19 pandemic. Front Psychiatry 2024; 14:1287036. [PMID: 38348360 PMCID: PMC10859463 DOI: 10.3389/fpsyt.2023.1287036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 12/08/2023] [Indexed: 02/15/2024] Open
Abstract
Objective We aimed to determine the association between a major romantic breakup and suicidal ideation in medical students from three universities in Peru. Methods A cross-sectional study was conducted during the first pandemic wave in 2021 on medical students from three universities in northern Peru. The outcome was suicidal ideation, measured with question nine of the Patient Health Questionnaire-9 (PHQ-9). Generalized Anxiety Disorder Scale-7 (GAD-7) and Insomnia Severity Index (ISI) were also used to assess mental health symptoms. The exposure was the experience of a major love breakup during the pandemic. In addition, its association with other covariates (age, sex, family members infected with COVID-19, deceased family members with COVID-19, insomnia, and anxiety, among others) was examined. Results and discussions Out of 370 students, 19.5% reported a major love breakup during the pandemic (95%CI: 15.5-23.8), and 34.3% had suicidal ideation (95%CI: 29.4-39.4). Having a major love breakup was associated with a higher prevalence of suicidal ideation (PR: 1.49, 95%CI: 1.32-1.67, p < 0.001). Moderate insomnia (PR: 2.56, 95%CI: 1.70-3.87, p < 0.001) and anxiety symptoms (PR: 1.94, 1.10-3.44, p = 0.023) were also associated with suicidal ideation. Conclusion Our study provides evidence of a significant association between a major love breakup and suicidal ideation. This finding emphasizes the need for further research to better understand this association and inform the development of effective suicide prevention policies in medical education.
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Affiliation(s)
- Danai Valladares-Garrido
- Escuela de Medicina, Universidad Cesar Vallejo, Trujillo, Peru
- Oficina de Salud Ocupacional, Hospital Santa Rosa, Piura, Peru
| | - J. Pierre Zila-Velasque
- Facultad de Medicina, Universidad Nacional Daniel Alcides Carrion, Pasco, Peru
- Red Latinoamericana de Medicina en la Altitud e Investigación (REDLAMAI), Pasco, Peru
| | - Flor M. Santander-Hernández
- Escuela de Medicina, Universidad Cesar Vallejo, Piura, Peru
- Sociedad Científica de Estudiantes de Medicina, Universidad Cesar Vallejo, Piura, Peru
| | - Miguel A. Guevara-Morales
- Escuela de Medicina, Universidad Cesar Vallejo, Piura, Peru
- Sociedad Científica de Estudiantes de Medicina, Universidad Cesar Vallejo, Piura, Peru
| | - Noelia Morocho-Alburqueque
- Escuela de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Nacional de Piura, Piura, Peru
| | - Virgilio E. Failoc-Rojas
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | | | - Víctor J. Vera-Ponce
- Instituto de Investigación en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Peru
- Universidad Tecnológica del Perú, Lima, Peru
| | | | - Mario J. Valladares-Garrido
- Facultad de Medicina Humana, Universidad de San Martín de Porres, Chiclayo, Peru
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima, Peru
- Oficina de Epidemiología, Hospital Regional Lambayeque, Chiclayo, Peru
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9
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Romero-Cabrera AB, Lindo-Cavero A, Villarreal-Zegarra D, Rodriguez V, Luna-Matos ML, Rojas-Mendoza WN, Huarcaya-Victoria J, Cuzcano-Gonzales KV, Gonzales-Gavancho C, Alarcon-Ruiz CA. Perception of personal protective equipment availability and mental health outcomes in workers from two national hospitals during the COVID-19 pandemic. Heliyon 2024; 10:e23327. [PMID: 38148804 PMCID: PMC10750142 DOI: 10.1016/j.heliyon.2023.e23327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 11/18/2023] [Accepted: 11/30/2023] [Indexed: 12/28/2023] Open
Abstract
Background During the first wave of the pandemic, a constant concern of healthcare workers, who are more vulnerable to contagion, is their personal safety. This is directly related to the availability of adequate PPE, which led to a perception of dissatisfaction and inequality with government responses. We aim t o determines whether perception of adequate PPE availability is associated with depressive, anxiety, and stress symptoms in different types of healthcare workers. Methods Analytical cross-sectional study surveyed clinical and non-clinical healthcare workers in two third-level hospitals in Lima, Peru. An online self-survey assessed the perception of adequate PPE availability, using a Likert scale question, which was then dichotomized for the analysis. In addition, we assessed the depressive, anxiety, and stress symptoms using validated questionnaires. Results 563 participants were included. In general, there is no association between perception of PPE availability and three mental health outcomes. However, in the subgroup analysis, physicians with better perception of PPE availability had less moderate-severe outcomes in mental health; in contrast, nurses had higher moderate-severe outcomes. The type of profession in healthcare workers may modify the effect of this association. Conclusion The association between perception of PPE availability and mental health outcomes is complex in healthcare workers from two third-level hospitals. This association can vary according to the type of work.
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Affiliation(s)
| | | | - David Villarreal-Zegarra
- Instituto Peruano de Orientación Psicológica, Lima, Peru
- Escuela de Psicología, Universidad Continental, Lima, Peru
| | - Vilma Rodriguez
- Departamento de Psiquiatría, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru
| | - Matilde L. Luna-Matos
- Departamento de Psiquiatría, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru
| | | | - Jeff Huarcaya-Victoria
- Departamento de Psiquiatría, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru
- Escuela Professional de Medicina Humana, Universidad Privada San Juan Bautista, Filial Ica, Peru
| | - K. Vanesa Cuzcano-Gonzales
- Instituto Peruano de Orientación Psicológica, Lima, Peru
- Facultad de Medicina Humana, Universidad de San Martin de Porres, Filial Norte, Chiclayo, Peru
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10
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Bazo-Alvarez JC, Aparicio ARO, Robles-Mariños R, Julca-Guerrero F, Gómez H, Bazo-Alvarez O, Cjuno J. Cultural adaptation to Bolivian Quechua and psychometric analysis of the Patient Health Questionnaire PHQ-9. BMC Public Health 2024; 24:129. [PMID: 38195478 PMCID: PMC10775527 DOI: 10.1186/s12889-023-17566-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/22/2023] [Indexed: 01/11/2024] Open
Abstract
OBJECTIVE Cultural adaptation of the Patient Health Questionnaire-PHQ-9 to Bolivian Quechua and analysis of the internal structure validity, reliability, and measurement invariance by sociodemographic variables. METHODS The PHQ-9 was translated and back-translated (English-Quechua-English) to optimise translation. For the cultural adaptation, experts, and people from the target population (e.g., in focus groups) verified the suitability of the translated PHQ-9. For the psychometric analysis, we performed a Confirmatory Factor Analysis (CFA) to evaluate internal validity, calculated α and ω indices to assess reliability, and performed a Multiple Indicator, Multiple Cause (MIMIC) model for evaluating measurement invariance by sex, age, marital status, educational level and residence. We used standard goodness-of-fit indices to interpret both CFA results. RESULTS The experts and focus groups improved the translated PHQ-9, making it clear and culturally equivalent. For the psychometric analysis, we included data from 397 participants, from which 73.3% were female, 33.0% were 18-30 years old, 56.7% reported primary school studies, 63.2% were single, and 62.0% resided in urban areas. In the CFA, the single-factor model showed adequate fit (Comparative Fit Index = 0.983; Tucker-Lewis Index = 0.977; Standardized Root Mean Squared Residual = 0.046; Root Mean Squared Error of Approximation = 0.069), while the reliability was optimal (α = 0.869-0.877; ω = 0.874-0.885). The invariance was confirmed across all sociodemographic variables (Change in Comparative Fit Index (delta) or Root Mean Square Error of Approximation (delta) < 0.01). CONCLUSIONS The PHQ-9 adapted to Bolivian Quechua offers a valid, reliable and invariant unidimensional measurement across groups by sex, age, marital status, educational level and residence.
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Affiliation(s)
- Juan Carlos Bazo-Alvarez
- Universidad Cesar Vallejo, Escuela de Medicina, Trujillo, Peru.
- Research Department of Primary Care and Population Health, University College London (UCL), London, UK.
| | | | | | | | - Heber Gómez
- Instituto de Investigación, Capacitación y Desarrollo Psicosocial y Educativo PSYCOPERU, Lima, Peru
- Ingeniería de Sistemas e Informática, Universidad Tecnológica del Perú, Lima, Peru
| | - Oscar Bazo-Alvarez
- Instituto de Investigación, Capacitación y Desarrollo Psicosocial y Educativo PSYCOPERU, Lima, Peru
- School of Medicine, Universidad San Juan Bautista, Lima, Peru
| | - Julio Cjuno
- Universidad Peruana Unión, Escuela Profesional de Psicología, Lima, Peru
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11
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Herrera-Perez E, Custodio N, Diaz M, Montesinos R, Chang A, Villafuerte M, Lanata S. Epidemiology of neurocognitive disorders in adults from urban-marginalized areas: a door-to-door population-based study in Puente Piedra, Lima, Peru. Front Public Health 2023; 11:1228008. [PMID: 37927880 PMCID: PMC10622761 DOI: 10.3389/fpubh.2023.1228008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
Background In Latin America (LA), the prevalence of dementia is expected to triple to 150 million people by 2050. The 2020 Lancet Commission report identified several modifiable dementia risk factors, yet few social and environmental factors, most relevant to vulnerable regions of LA, were highlighted in this report. We sought to assess the epidemiology of neurocognitive disorders (NCD) in Puente Piedra, one of the most socially and economically vulnerable districts of Lima, the capital of Peru. Methodology This was a cross-sectional door-to-door observational study that used two-stage household sampling. One young adult (30-59 years) and one older adult (>60 years) per household were enrolled. We collected demographic, clinical, and neurocognitive data. Addenbrooke's Cognitive Examination (young adults) and the RUDAS-PE (older adults) were used, classifying participants as cognitively normal, possible mild NCD, or possible major NCD. Results We enrolled 247 participants (median age 46 years; 67% female). One-fourth had not completed secondary school and more than 50% completed only secondary school. Most participants were housewives (46%) and 21% did not have health insurance. The overall prevalence of possible NCD was 30% (25.6 and 41.8% among younger adults and older adults, respectively). Among younger adults, those ages 55-59 years more frequently had NCD (70%) compared to younger age ranges. Among older adults, only 3 subjects (4.5%) had major NCD. Conclusion We found a high frequency of possible NCDs in a socially and economically vulnerable community in Lima, Peru, with younger adults showing levels of NCD higher than expected. Our findings support the need for health systems to incorporate cognitive screenings programs for NCD in younger ages. Future research on NCD would include younger populations, particularly in vulnerable communities.
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Affiliation(s)
- Eder Herrera-Perez
- Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Centro de Excelencia en Biotecnología e Investigación Traslacional, Lima, Peru
| | - Nilton Custodio
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | - Monica Diaz
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Rosa Montesinos
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
| | - Alexandra Chang
- Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | | | - Serggio Lanata
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
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12
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Ramírez-Bontá F, Vásquez-Vílchez R, Cabrera-Alva M, Otazú-Alfaro S, Almeida-Huanca G, Ambrosio-Melgarejo J, Figueroa-Quiñones J, Romero-Cabrera AB, Huaman-Santa Cruz A, Chávez-Hinostroza E, Rosado-Medina M, Siancas-Villano W, Quintana-Castro C, Bazo-Alvarez JC, Villarreal-Zegarra D. Mental health data available in representative surveys conducted in Latin America and the Caribbean countries: a scoping review. BMJ Open 2023; 13:e069861. [PMID: 37798035 PMCID: PMC10565329 DOI: 10.1136/bmjopen-2022-069861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 08/23/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Mental health data from Latin America and the Caribbean countries (LACC) national and international surveys are essential for public health surveillance. This review aimed to identify and describe available mental health survey data in LACC, providing access details for researchers. METHODS Our study was a scoping review. The search for available mental health survey data was conducted in PubMed and through grey literature searches, and the search dates were between 26 August 2021 and 15 October 2021. Included survey data were/had (1) nationally representative, (2) the latest version available from 2012 onward, (3) collected in at least one LACC and (4) at least one mental health variable or related factor. We accepted all written languages, including Spanish and English. RESULTS A total of 56 national and 13 international surveys were included, with data available on 95 mental health variables classified into 10 categories. Most national surveys were performed in upper-middle-income countries. Variables categorised as 'Substance use' and 'Violence' were the most frequent. Mexico and Colombia had the highest production in both the national and international surveys. The main target population was the adult population. However, there are several mental health topics and LACC yet unsurveyed. CONCLUSION We identified a total of 69 representative surveys from LACCs since 2012. We categorised the available data on mental health variables into 10 categories, and provided technical details to facilitate the future selection and use of these surveys.
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Affiliation(s)
- Francesca Ramírez-Bontá
- Instituto Peruano de Orientación Psicológica, Lima, Peru
- Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Rafaela Vásquez-Vílchez
- Instituto Peruano de Orientación Psicológica, Lima, Peru
- Universidad Nacional Mayor de San Marcos, Lima, Peru
| | | | | | | | - Juan Ambrosio-Melgarejo
- Instituto Peruano de Orientación Psicológica, Lima, Peru
- Centro Nacional Salud Ocupacional y Protección del Ambiente para la Salud, Instituto Nacional de Salud, Lima, Peru
| | | | | | - Anayeli Huaman-Santa Cruz
- Instituto Peruano de Orientación Psicológica, Lima, Peru
- Universidad Nacional Mayor de San Marcos, Lima, Peru
| | | | | | - Wildo Siancas-Villano
- Instituto Peruano de Orientación Psicológica, Lima, Peru
- Universidad San Ignacio de Loyola, Lima, Peru
| | | | - Juan Carlos Bazo-Alvarez
- Research Department of Primary Care and Population Health, University College London, London, UK
- Universidad Privada Norbert Wiener, Lima, Peru
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Villarreal-Zegarra D, Copez-Lonzoy A, Cabrera-Alva M, Torres-Puente R, Melendez-Torres GJ. Psychometric Adaptation of a Brief Scale of Child-to-Parent Violence and Intrafamily Violence in Peruvian Adolescents. VIOLENCE AND VICTIMS 2023; 38:627-644. [PMID: 37827580 DOI: 10.1891/vv-2022-0059] [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: 10/14/2023]
Abstract
Family violence is a critical public health problem in Latin America. In Peru, family violence continues to be difficult to detect and prevent, with child-to-parent violence (CPV) arising as a key issue. This study aimed to do a psychometric adaptation of a brief scale of evaluation of CPV and intrafamily violence in a sample of Peruvian adolescents. Our study analyzed internal structure, internal consistency (with depression, family satisfaction, and anxiety), convergent validity, and measurement invariance. The study population included 570 adolescents living with both parents (50.2% women). Adequate goodness-of-fit indices were found for the full version of CPV and intrafamily violence of nine items (CFI = 0.991; RMSEA = 0.053) and the version with only CPV of six items (CFI = 0.995; RMSEA = 0.074). The latent correlations between CPV with depressive symptoms and anxiety symptoms were greater than 0.40. Our study found that the full version of CPV and intrafamily violence (nine items) and the CPV-only version (six items) were invariant by sex. Reliability was adequate in all cases (ω > 0.70). The scale presents evidence of validity and reliability in Peruvian adolescents. It is suitable for epidemiological research on family violence.
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Affiliation(s)
- David Villarreal-Zegarra
- Escuela de Medicina, Universidad César Vallejo, Trujillo, Peru
- Instituto Peruano de Orientación Psicológica, Lima, Peru
| | - Anthony Copez-Lonzoy
- Instituto Peruano de Orientación Psicológica, Lima, Peru
- Universidad San Ignacio de Loyola, Unidad de investigación en Bibliometría, Lima, Peru
| | | | | | - G J Melendez-Torres
- Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
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14
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Villarreal-Zegarra D, Barrera-Begazo J, Otazú-Alfaro S, Mayo-Puchoc N, Bazo-Alvarez JC, Huarcaya-Victoria J. Sensitivity and specificity of the Patient Health Questionnaire (PHQ-9, PHQ-8, PHQ-2) and General Anxiety Disorder scale (GAD-7, GAD-2) for depression and anxiety diagnosis: a cross-sectional study in a Peruvian hospital population. BMJ Open 2023; 13:e076193. [PMID: 37714674 PMCID: PMC10510859 DOI: 10.1136/bmjopen-2023-076193] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/21/2023] [Indexed: 09/17/2023] Open
Abstract
OBJECTIVES The Patient Health Questionnaire (PHQ) and Generalised Anxiety Disorder Scale (GAD) are widely used screening tools, but their sensitivity and specificity in low-income and middle-income countries are lower than in high-income countries. We conducted a study to determine the sensitivity and specificity of different versions of these scales in a Peruvian hospital population. DESIGN Our study has a cross-sectional design. SETTING Our participants are hospitalised patients in a Peruvian hospital. The gold standard was a clinical psychiatric interview following ICD-10 criteria for depression (F32.0, F32.1, F32.2 and F32.3) and anxiety (F41.0 and F41.1). PARTICIPANTS The sample included 1347 participants. A total of 334 participants (24.8%) were diagnosed with depression, and 28 participants (2.1%) were diagnosed with anxiety. RESULTS The PHQ-9's≥7 cut-off point showed the highest simultaneous sensitivity and specificity when contrasted against a psychiatric diagnosis of depression. For a similar contrast against the gold standard, the other optimal cut-off points were: ≥7 for the PHQ-8 and ≥2 for the PHQ-2. In particular, the cut-off point ≥8 had good performance for GAD-7 with sensitivity and specificity, and cut-off point ≥10 had lower levels of sensitivity, but higher levels of specificity, compared with the cut-off point of ≥8. Also, we present the sensitivity and specificity values of each cut-off point in PHQ-9, PHQ-8, PHQ-2, GAD-7 and GAD-2. We confirmed the adequacy of a one-dimensional model for the PHQ-9, PHQ-8 and GAD-7, while all PHQ and GAD scales showed good reliability. CONCLUSIONS The PHQ and GAD have adequate measurement properties in their different versions. We present specific cut-offs for each version.
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Affiliation(s)
- David Villarreal-Zegarra
- Escuela de Medicina, Universidad César Vallejo, Trujillo, Peru
- Instituto Peruano de Orientación Psicológica, Lima, Peru
| | | | | | | | - Juan Carlos Bazo-Alvarez
- Research Department of Primary Care and Population Health, University College London (UCL), London, UK
| | - Jeff Huarcaya-Victoria
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Ica, Peru
- Unidad de Psiquiatría de Enlace, Departamento de Psiquiatría, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
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15
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Villarreal-Zegarra D, Reátegui-Rivera CM, Otazú-Alfaro S, Yantas-Alcantara G, Soto-Becerra P, Melendez-Torres GJ. Estimated impact of the COVID-19 pandemic on the prevalence and treatment of depressive symptoms in Peru: an interrupted time series analysis in 2014-2021. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1375-1385. [PMID: 36884090 PMCID: PMC9993377 DOI: 10.1007/s00127-023-02446-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 02/27/2023] [Indexed: 03/09/2023]
Abstract
PURPOSE The COVID-19 pandemic increased the burden of mental disorders worldwide. Peru has been one of the countries most affected by COVID-19, however, studies evaluating the medium and long-term consequences of the pandemic on Peruvians' mental health are recent and represent a new field of study in proliferation. We aimed to estimate the impact of the COVID-19 pandemic on the prevalence and treatment of depressive symptoms using nationally representative surveys in Peru. METHODS Our study is an analysis of secondary data. We carried out a time series cross-sectional analysis based on the National Demographic and Health Survey of Peru, collected using a complex sampling design. The Patient Health Questionnaire-9 was used to measure mild (5-9 points), moderate (10-14 points), and severe (15 points or more) depressive symptoms. The participants were men and women aged 15 years and older, living in urban and rural areas of all regions of Peru. The main statistical analysis used segmented regression with Newey-West standard errors, taking into account that each year of the evaluation was divided into four measures (quarter measure). RESULTS We included 259,516 participants. An average quarterly increase of 0.17% (95% CI 0.03-0.32%) in the prevalence of moderate depressive symptoms was identified after the onset of the COVID-19 pandemic (approximately an increase of 1583 new cases of moderate depressive symptoms by each quarter). The percentage of cases treated for mild depressive symptoms increased quarterly by an average of 0.46% (95% CI 0.20-0.71%) after the onset of the COVID-19 pandemic (approximately an increase of 1242 new cases treated for mild depressive symptoms by each quarter). CONCLUSION In Peru, increases in the prevalence of moderate depressive symptoms and the proportion of cases treated with mild depressive symptoms were found after the COVID-19 pandemic. Therefore, this study is a precedent for future research assessing the prevalence of depressive symptoms and the proportion of cases receiving treatment during the pandemic and post-pandemic years.
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Affiliation(s)
- David Villarreal-Zegarra
- Escuela de Medicina, Universidad César Vallejo, Trujillo, Peru
- Instituto Peruano de Orientación Psicológica, Lima, Peru
| | - C. Mahony Reátegui-Rivera
- Instituto Peruano de Orientación Psicológica, Lima, Peru
- Unidad de Telesalud, Universidad Nacional Mayor de San Marcos, Lima, Peru
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Lee EH, Kang EH, Kang HJ, Lee HY. Measurement invariance of the patient health questionnaire-9 depression scale in a nationally representative population-based sample. Front Psychol 2023; 14:1217038. [PMID: 37720651 PMCID: PMC10500305 DOI: 10.3389/fpsyg.2023.1217038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 08/16/2023] [Indexed: 09/19/2023] Open
Abstract
The Patient Health Questionnaire-9 (PHQ-9) is widely used to measure the severity of depressive symptoms and to screen for depressive disorder, but its measurement invariance has received little research attention. The aim of this study was to assess the measurement invariance of the PHQ-9 across various sociodemographic and medical-condition groups. The structural validity and internal consistency of the PHQ-9 were also assessed as the prerequisite properties for measurement invariance. This study was conducted using data from the Korea National Health and Nutrition Examination Survey. The included participants comprised 5,347 people older than 19 years. Exploratory graph analysis (EGA) and confirmatory factor analysis (CFA) were performed to determine structural validity, and the omega coefficient (ω ) was used to determine internal consistency. Measurement invariance (configural, metric, and scalar invariance) was evaluated using multigroup confirmatory factor analysis (MGCFA). The single structural model of the PHQ-9 that was validated by EGA was also satisfactory with fit indices of χ2 = 770.765 (p < 0.001), CFI = 0.944, SRMR = 0.040, and RMSEA = 0.076 (90% CI = 0.072-0.081). The ω of the PHQ-9 was 0.812, implying satisfactory internal consistency. The one-factor PHQ-9 had equivalent overall structure, factor loadings, and item intercepts across age groups, suggesting invariance across ages. Partial scalar invariance was demonstrated across sex and marital-status groups. Partial metric and scalar invariance were supported across education groups. Scalar invariance was supported among all of the medical-condition (hypertension, diabetes, cancer, arthritis, asthma, and heart disease) groups. Overall, the measurement invariance of the one-factor PHQ-9 was empirically supported across sociodemographic and medical-condition groups. The PHQ-9 can be reliably used to compare the severity of depressive symptoms across these groups in research and practice.
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Affiliation(s)
- Eun-Hyun Lee
- Graduate School of Public Health, Ajou University, Suwon, Republic of Korea
| | - Eun Hee Kang
- Graduate School of Public Health, Ajou University, Suwon, Republic of Korea
| | - Hyun-Jung Kang
- Graduate School of Public Health, Ajou University, Suwon, Republic of Korea
| | - Hyun Young Lee
- Clinical Trial Center, Ajou University Hospital, Suwon, Republic of Korea
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Landa-Blanco M, Cortés-Ramos A, Vásquez G, Reyes Y, Echenique Y. Psychometric properties of the Spanish version of the Flourishing Scale in the Honduran population. Front Psychol 2023; 14:1223269. [PMID: 37546485 PMCID: PMC10398334 DOI: 10.3389/fpsyg.2023.1223269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/03/2023] [Indexed: 08/08/2023] Open
Abstract
Studying Flourishing is important to understand wellbeing. The current study aimed to determine the psychometric properties of the Spanish version of the Flourishing Scale (FS) in the Honduran population. The primary sample consisted of 422 residents of the Central District of Honduras; this included 275 (65.17%) women and 147 men (34.83%). Their average age was 28.18 years (SD = 10.58). Findings from the Exploratory Factor Analysis and Confirmatory Factor Analysis support a unidimensional factor structure. The FS achieved a high internal consistency with McDonald's ω = 0.89, 95% CI [0.86, 0.91]. The average inter-item correlation was 0.48, 95% CI [0.43, 0.53]. Using Student's t-test for paired samples, results indicate that none of the FS items varied significantly between baseline and post-test. Additionally, Spearman's rho was used to correlate test-retest scores; this yielded a statistically significant correlation coefficient of 0.66. The Flourishing Scale had adequate convergent validity with the Subjective Happiness Scale (r = 0.70) and the PANAS-Positive Affect Subscale (r = 0.70) (p < 0.001). In contrast, it correlates inversely with the PANAS-Negative Affect Subscale (r = -0.34) and the PHQ-9 (r = -0.51). Strict measurement invariance for sex was supported. The results indicate that the Flourishing Scale has robust psychometric properties for the Honduran population. Practical implications for public policy are discussed.
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Affiliation(s)
- Miguel Landa-Blanco
- Master’s Degree in Clinical Psychology, School of Psychological Sciences, National Autonomous University of Honduras, Tegucigalpa, Honduras
| | - Antonio Cortés-Ramos
- Department of Developmental Psychology and Education, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
| | - Gabriela Vásquez
- Master’s Degree in Clinical Psychology, School of Psychological Sciences, National Autonomous University of Honduras, Tegucigalpa, Honduras
| | - Yarell Reyes
- Master’s Degree in Clinical Psychology, School of Psychological Sciences, National Autonomous University of Honduras, Tegucigalpa, Honduras
| | - Yarani Echenique
- Master’s Degree in Clinical Psychology, School of Psychological Sciences, National Autonomous University of Honduras, Tegucigalpa, Honduras
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Valladares-Garrido MJ, Zapata-Castro LE, García-Vicente A, León-Figueroa DA, Huamani-Colquichagua Y, Huaman-Garcia M, Calle-Preciado RE, Valladares-Garrido D, Díaz-Vélez C, Failoc-Rojas VE, Vera-Ponce VJ, Pereira-Victorio CJ. Food insecurity in Piura, Peru, in the context of post-earthquake and the COVID-19 pandemic. Front Public Health 2023; 11:1142550. [PMID: 37529432 PMCID: PMC10389717 DOI: 10.3389/fpubh.2023.1142550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 06/13/2023] [Indexed: 08/03/2023] Open
Abstract
Introduction Piura, located in a seismic zone, faces challenges related to food security. The aim of this study was to analyze aspects related to food insecurity in the region following the 6.1-magnitude earthquake that occurred in 2021, within the context of the COVID-19 pandemic. Methods A secondary analysis was performed in 177 people exposed to the earthquake in Piura. Food insecurity was assessed with the Household Food Insecurity Access Scale. Its association with insomnia, resilience, anxiety/depressive symptoms, and general variables were determined using generalized linear models. Results Food insecurity was observed in 31.1% (95% CI: 24.3-38.4) of participants. This prevalence was higher in people with mild (PR: 1.73, 95% CI: 1.12-2.70) and moderate (PR: 1.55, 95% CI: 1.09-2.22) anxiety symptoms, severe depressive symptoms (PR: 2.74, 95% CI: 1.24-6.03), and previous exposure to the El Niño Phenomenon (PR: 1.72; 95% CI: 1.06-2.81). An income higher than 5000 Peruvian soles (approximately 1300 US dollars) was associated with a lower prevalence of food insecurity (PR: 0.22, 95% CI: 0.13-0.40). Conclusions Overall, three out of 10 individuals experienced food insecurity after the 2021 earthquake in Piura. Food insecurity may be aggravated by mental disorders, previous exposure to the El Niño phenomenon, and the COVID-19 pandemic. Our study contributes to the field by exploring a range of variables related to food insecurity in a unique context: post-earthquake and during the COVID-19 health emergency in Peru. These findings enhance our understanding of food insecurity at the regional level and highlight the need for preventive food security programs in seismic events.
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Affiliation(s)
- Mario J. Valladares-Garrido
- Escuela de Medicina, Universidad Cesar Vallejo, Piura, Peru
- Oficina de Epidemiología, Hospital Regional Lambayeque, Chiclayo, Peru
| | | | | | - Darwin A. León-Figueroa
- Emerge, Unidad de Investigación en Enfermedades Emergentes y Cambio Climático, Lima, Peru
- Faculty of Medicine, Universidad de San Martín de Porres, Chiclayo, Peru
| | | | | | | | - Danai Valladares-Garrido
- Escuela de Medicina, Universidad Cesar Vallejo, Piura, Peru
- Unidad de Epidemiología y Salud Ambiental, Hospital de Apoyo II Santa Rosa, Piura, Peru
| | - Cristian Díaz-Vélez
- Faculty of Medicine, Universidad Privada Antenor Orrego, Trujillo, Peru
- Red Peruana de Salud Colectiva, Lima, Peru
| | - Virgilio E. Failoc-Rojas
- Unidad de investigación para la generación y síntesis de evidencias en salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Víctor J. Vera-Ponce
- Instituto de Investigación en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Peru
- Facultad de Psicologia, Universidad Tecnológica del Perú, Lima, Peru
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Villarreal-Zegarra D, Otazú-Alfaro S, Segovia-Bacilio P, García-Serna J, Reategui-Rivera CM, Melendez-Torres GJ. Profiles of depressive symptoms in Peru: An 8-year analysis in population-based surveys. J Affect Disord 2023; 333:384-391. [PMID: 37086796 DOI: 10.1016/j.jad.2023.04.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 04/24/2023]
Abstract
Background Profiles of depressive symptoms have been described due to heterogeneity in symptomatology and presentation. In our study, we estimate depressive symptom profiles and relate these symptom profiles to risk factors in the Peruvian population. Methods We carried out an observational study based on the Peruvian Demographic and Health Survey (2014-2022). Men and women aged 15 years and older living in urban and rural areas in all regions of Peru were included. The Patient Health Questionnaire-9 was used to define depressive symptom profiles. We estimated latent class models to define the profiles and performed a Poisson regression analysis to determine the associated factors. Results A total of 259,655 participants were included. The three-class model was found to be the most appropriate, and the classes were defined according to the severity of depressive symptoms (moderate-severe symptoms, mild symptoms, and without depressive symptoms). Also, it was found that the three classes identified have not changed during the years of evaluations, presenting very similar prevalence over the years. In addition, women are more likely than men to belong to a class with more severe depressive symptoms; and the older the age, the higher the probability of belonging to a class with greater severity of depressive symptoms. Conclusions Our study found that at the population level in Peru, depressive symptoms are grouped into three classes according to the intensity of the symptomatology present (no symptoms, mild symptoms and moderate-severe symptoms).
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Affiliation(s)
- David Villarreal-Zegarra
- Escuela de Medicina, Universidad César Vallejo, Trujillo, Peru; Instituto Peruano de Orientación Psicológica, Lima, Peru.
| | | | | | | | - C Mahony Reategui-Rivera
- Instituto Peruano de Orientación Psicológica, Lima, Peru; Unidad de Telesalud, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru.
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20
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Huarcaya-Victoria J, Elera-Fitzcarrald C, Crisol-Deza D, Villanueva-Zúñiga L, Pacherres A, Torres A, Huertas G, Calderón D, Noriega-Baella C, Astonitas E, Salvador-Carrillo J. Factors associated with mental health in Peruvian medical students during the COVID-19 pandemic: a multicentre quantitative study. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2023; 52:236-244. [PMID: 37923417 DOI: 10.1016/j.rcpeng.2021.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 06/02/2021] [Indexed: 11/07/2023]
Abstract
OBJECTIVE To assess the mental health status and associated factors of Peruvian medical students during the COVID-19 pandemic. METHODS Descriptive, multicentre, correlational study that used the "Patient Health Questionnaire-9 (PHQ-9)", the "Generalized Anxiety Disorder-7 (GAD-7)" and the "Impact of Event Scale-Revised (IES-R)" questionnaires to evaluate mental health problems. RESULTS A total of 1,238 students from 8 Peruvian medical schools participated in the study. Of these, 68.5% were women, and the mean age was 21.4 years. Depressive symptoms were found in 74% of the participants, anxiety symptoms in 57% and distress symptoms in 65%. The variables associated with the development of symptoms of moderate-severe depression, anxiety and distress were: not having family economic stability, being in the first years of medical training, being female, and fearing that their medical training would be delayed and impaired. CONCLUSIONS In a sample of medical students surveyed during the COVID-19 pandemic, mental health problems were common. The factors associated with mental health reported in this study could be useful in identifying vulnerable medical students who require timely psychosocial support and/or psychiatric care.
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Affiliation(s)
- Jeff Huarcaya-Victoria
- Centro de Investigación en Salud Pública, Facultad de Medicina, Universidad de San Martín de Porres, Lima, Perú
| | | | - Diego Crisol-Deza
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Perú; Red de Eficacia Clínica y Sanitaria, REDECS, Lima, Perú
| | | | - Andrés Pacherres
- Centro de Investigación en Educación Médica, Faculta de Medicina Humana, Universidad de San Martín de Porres, Lima, Perú
| | - Allison Torres
- Facultad de Medicina Humana, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Grace Huertas
- Facultad de Medicina Humana, Universidad Privada Antenor Orrego, Trujillo, Perú
| | | | | | - Erik Astonitas
- Facultad de Medicina San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Perú
| | - José Salvador-Carrillo
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Filial Chincha, Perú; Instituto de Investigación de Interculturalidad, Universidad Privada San Juan Bautista, Perú
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21
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Cjuno J, Julca-Guerrero F, Oruro-Zuloaga Y, Cruz-Mendoza F, Auccatoma-Quispe A, Gómez Hurtado H, Peralta-Alvarez F, Bazo-Alvarez JC. Cultural adaptation to quechua and psychometric analysis of the patient health questionnaire (PHQ-9) in a peruvian population. Rev Peru Med Exp Salud Publica 2023; 40:267-277. [PMID: 37991030 PMCID: PMC10959517 DOI: 10.17843/rpmesp.2023.403.12571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 09/06/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVE . To translate and culturally adapt the Patient Health Questionnaire (PHQ-9) to three varieties of Quechua and analyse their validity, reliability, and measurement invariance. MATERIALS AND METHODS . 1) Cultural adaptation phase: the PHQ-9 was translated from English into three variants of Quechua (Central, Chanca, Cuzco-Collao) and translated again into English. Then, experts and focus groups allowed the translations to be culturally adapted. 2) Psychometric phase: the unidimensionality of the adapted PHQ-9 was evaluated by using Confirmatory Factor Analysis (CFA), reliability was evaluated by internal consistency (Alpha and Omega), and measurement invariance according to Quechua varieties and sociodemographic variables was evaluated by using CFA, multigroups and MIMIC models (Multiple Indicator Multiple Cause). RESULTS . Each of the adaptations of the PHQ-9 to the three Quechua varieties reported clear and culturally equivalent items. Subsequently, data from 970 Quechua-speaking adult men and women were analyzed. The general one-dimensional model reported an adequate fit (Comparative fit index = 0.990, Tucker-Lewis index = 0.987, Standardized root mean squared residual= 0.048, Root mean squared error of approximation=0.071); each of the Quechua varieties also showed an adequate fit. Reliability was high for all varieties (α = 0.865 - 0.915; ω = 0.833 - 0.881). The results of the multigroup CFA and MIMIC models confirmed measurement invariance according to Quechua variant, sex, residence, age, marital status and educational level. CONCLUSIONS . The PHQ-9 adaptations to Central Quechua, Chanca and Cuzco-Collao offer a valid, reliable and invariant measurement, confirming that comparisons can be made between the evaluated groups. Its use will benefit mental health research and care for Quechua-speaking populations.
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Affiliation(s)
- Julio Cjuno
- Universidad Cesar Vallejo, Faculty of Medicina, Piura, Peru.Universidad Cesar VallejoUniversidad Cesar VallejoFaculty of MedicinaPiuraPeru
| | - Félix Julca-Guerrero
- Universidad Nacional Santiago Antúnez de Mayolo, Huaraz, PeruUniversidad Nacional Santiago Antúnez de MayoloUniversidad Nacional Santiago Antúnez de MayoloHuarazPeru
| | - Yulisa Oruro-Zuloaga
- Universidad Peruana Unión, Professional School of Psychology, Lima, Peru.Universidad Peruana UniónUniversidad Peruana UniónProfessional School of PsychologyLimaPeru
| | - Frinee Cruz-Mendoza
- Escuela de Educación superior pedagógico José Salvador Cavero Ovalle, Ayacucho, Peru.Escuela de Educación superior pedagógico José Salvador Cavero OvalleAyacuchoPeru
| | - Admirson Auccatoma-Quispe
- Educational Institution N° 38848 Pucara-Uchuraccay, Ayacucho, PeruEducational Institution N° 38848 Pucara-UchuraccayAyacuchoPeru
| | - Heber Gómez Hurtado
- Universidad Tecnológica del Perú, Chimbote, Peru.Universidad Tecnológica del PerúUniversidad Tecnológica del PerúChimbotePeru
- Institute for Psychosocial and Educational Research, Training and Development PSYCOPERU, Chimbote, Peru.Institute for Psychosocial and Educational Research, Training and Development PSYCOPERUChimbotePeru
| | | | - Juan Carlos Bazo-Alvarez
- Universidad Privada Norbert Wiener, Lima, Peru.Universidad Privada Norbert WienerUniversidad Privada Norbert WienerLimaPeru
- Research Department of Primary Care and Population Health, University College London, London, United KingdomUniversity College LondonResearch Department of Primary Care and Population HealthUniversity College LondonLondresUnited Kingdom
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22
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Valladares-Garrido MJ, León-Figueroa DA, Dawson FM, Burga-Cachay SC, Fernandez-Canani MA, Failoc-Rojas VE, Pereira-Victorio CJ, Valladares-Garrido D, Inga-Berrospi F. Association between childhood trauma and mental health disorders in adolescents during the second pandemic wave of COVID-19, Chiclayo-Peru. Front Psychiatry 2023; 14:1169247. [PMID: 37426089 PMCID: PMC10323439 DOI: 10.3389/fpsyt.2023.1169247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 05/10/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction The COVID-19 pandemic has significantly affected mental health, with children and adolescents being particularly vulnerable. Evidence on the association between childhood trauma and mental health outcomes in schoolchildren during the pandemic is limited. This study aimed to evaluate this relationship in Chiclayo city, northern Peru, during the second wave of COVID-19. Methods A cross-sectional secondary data study was conducted, measuring childhood trauma using the Marshall's Trauma Scale, depressive symptomatology (PHQ-9), and anxiety symptomatology (GAD-7). Additional variables assessed were alcohol use (AUDIT), resilience (abbreviated CD-RISC), and socio-educational data. Prevalence ratios were estimated using generalized linear models. Results Among 456 participants, 88.2% were female, with a mean age of 14.5 years (SD: 1.33). Depressive symptomatology prevalence was 76.3% (95%CI: 72.14-80.15) and increased by 23% in schoolchildren with childhood trauma (PR: 1.23; 95%CI: 1.10-1.37). Factors positively associated with depressive symptomatology included increasing age, seeking mental health help during the pandemic, and severe family dysfunction. Anxiety symptomatology prevalence was 62.3% (95%CI: 57.65-66.75) and increased by 55% in schoolchildren with childhood trauma (PR: 1.55; 95%CI: 1.31-1.85). Anxiety symptomatology was positively associated with mild, moderate, and severe family dysfunction. Conclusion Schoolchildren exposed to childhood trauma are at increased risk for depressive and anxiety symptoms. Monitoring the impact of the COVID-19 pandemic on adolescent mental health is vital. These findings can assist schools in establishing effective measures to prevent mental health outcomes.
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Affiliation(s)
| | - Darwin A. León-Figueroa
- Facultad de Medicina Humana, Universidad de San Martín de Porres, Chiclayo, Peru
- Centro de Investigación en Atención Primaria de Salud, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | | | | | - Virgilio E. Failoc-Rojas
- Research Unit for Generation and Synthesis Evidence in Health, Universidad San Ignacio de Loyola, Lima, Peru
| | | | - Danai Valladares-Garrido
- Escuela de Medicina, Universidad Cesar Vallejo, Piura, Peru
- Unidad de Epidemiología y Salud Ambiental, Hospital de Apoyo II Santa Rosa, Piura, Peru
| | - Fiorella Inga-Berrospi
- Grupo de Investigación en Gestión y Salud Pública, Universidad Norbert Wiener, Lima, Peru
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23
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Saunders R, Moinian D, Stott J, Delamain H, Naqvi SA, Singh S, Wheatley J, Pilling S, Buckman JEJ. Measurement invariance of the PHQ-9 and GAD-7 across males and females seeking treatment for common mental health disorders. BMC Psychiatry 2023; 23:298. [PMID: 37118684 PMCID: PMC10148535 DOI: 10.1186/s12888-023-04804-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 04/19/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND The nine-item Patient Health Questionnaire (PHQ-9) and the seven-item Generalised Anxiety Disorder scale (GAD-7) scales are routinely used in research and clinical practice. Whilst measurement invariance of these measures across gender has been demonstrated individually in general population studies and clinical samples, less is known about invariance of the distinct but correlated latent factors ('depression' and 'anxiety'). The current study assessed measurement invariance of these constructs across males and females seeking treatment for common mental health disorders. METHODS Data were provided from eight psychological treatment services in London, England. Data from initial assessments with the services where individual items on the PHQ-9 and GAD-7 were available were included in analyses. Measurement invariance was explored across self-identified genders, with 'male' and 'female' categories available in the dataset. Sensitivity analyses were conducted using propensity score matching on sociodemographic and clinical variables. RESULTS Data were available for 165,872 patients (110,833 females, 55,039 males). There was evidence of measurement invariance between males and females in both the full sample and a propensity score matched sample (n = 46,249 in each group). CONCLUSIONS Measurement invariance of the correlated depression and anxiety factors of PHQ-9 and GAD-7 were indicated in this sample of individuals seeking psychological treatment for CMHDs. These results support the use of these measures in routine clinical practice for both males and females. This is of particular importance for assessing the prevalence of clinically significant levels of symptoms as well as comparing treatment outcomes across genders.
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Affiliation(s)
- Rob Saunders
- CORE Data Lab, Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational and Health Psychology, UCL, London, UK.
| | - Delilah Moinian
- CORE Data Lab, Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational and Health Psychology, UCL, London, UK
| | - Joshua Stott
- ADAPT Lab, Research Department of Clinical, Educational and Health Psychology, UCL, London, UK
| | - Henry Delamain
- CORE Data Lab, Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational and Health Psychology, UCL, London, UK
| | - Syed Ali Naqvi
- Barking & Dagenham and Havering IAPT Services, North East London NHS Foundation Trust, London, UK
| | - Satwant Singh
- Waltham Forest Talking Therapies, North East London NHS Foundation Trust, London, UK
| | - Jon Wheatley
- Talk Changes: City & Hackney IAPT Service, Homerton University Hospital NHS Foundation Trust, London, UK
| | - Stephen Pilling
- CORE Data Lab, Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational and Health Psychology, UCL, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Joshua E J Buckman
- CORE Data Lab, Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational and Health Psychology, UCL, London, UK
- iCope - Camden and Islington Psychological Therapies Services, Camden & Islington NHS Foundation Trust, London, UK
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24
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Nguyen TPT, Do AL, Do HN, Vu TMT, van Kessel R, Wong BLH, Boyer L, Fond G, Auquier P, Nguyen TT, Latkin CA, Ho CSH, Ho RCM. Evidence of internal structure of the transactional eHealth literacy among Vietnamese youth: An instrument validation study. Front Public Health 2023; 11:1036877. [PMID: 37033078 PMCID: PMC10079874 DOI: 10.3389/fpubh.2023.1036877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Background The progression into the Digital Age has brought an array of novel skill requirements. Unlike traditional literacy, there are currently few measures that can reliably measure eHealth literacy. The Transactional Model of eHealth Literacy and subsequent Transactional eHealth Literacy Instrument may provide a feasible option for measuring eHealth literacy. Objective This instrument has yet to be validated, which is the aim of this study. In particular, this article was conducted to validate the TeHLI to see which components of the tool (how many and which components included) would be the best fit statistically and whether the tool applies to groups of different characteristics. Methods We conducted an online cross-sectional study among 236 Vietnamese young people. A exploratory factor analysis was used to identify the best fit model of the Transactional eHealth Literacy Instrument. A confirmatory factor analysis tested measurement invariance at four levels: configural, metric, scalar, and strict invariance. Only metric invariance was partially invariant, while the rest tested fully invariant. Even with partial metric invariance, there is reason to assume that functional, communicative, critical, and translational eHealth literacy (the four levels according to the transactional model) are consistently measured when deploying the Transactional eHealth Literacy Instrument across groups. Results The study findings substantiate that the most optimal composition of the TeHLI consists of four factors: functional, communicative, critical, and translational eHealth literacy, with RMSEA = 0.116; CFI = 0.907, and the highest internal consistency (Cronbach's α = 0.91, 0.92, 0.88, and 0.92 for each factor respectively). After using measurement invariance, that gender, education, marital status, age, location, and household economy do not influence the way participants to respond to the TeHLI to the point that would introduce measurement bias. In other word, using TeHLI across population groups should not produce error margins that substantially differ from each other. Conclusions This study suggests the instrument can be used for comparisons across groups and has the potential to generate high-quality data usable for informing change agents as to whether a particular population is proficient enough to adopt novel eHealth innovations.
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Affiliation(s)
- Thao Phuong Thi Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Faculty of Nursing, Duy Tan University, Da Nang, Vietnam
| | - Anh Linh Do
- Institute of Health Economics and Technology, Hanoi, Vietnam
| | - Ha Ngoc Do
- Youth Research Institute, Ho Chi Minh Communist Youth Union, Hanoi, Vietnam
| | | | - Robin van Kessel
- Department of International Health, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
- Research Committee, Global Health Workforce Network (GHWN) Youth Hub, World Health Organization, Geneva, Switzerland
| | - Brian Li Han Wong
- Research Committee, Global Health Workforce Network (GHWN) Youth Hub, World Health Organization, Geneva, Switzerland
- Medical Research Council Unit for Lifelong Health and Ageing at UCL, Department of Population Science and Experimental Medicine, UCL Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Laurent Boyer
- EA 3279, CEReSS, Research Centre on Health Services and Quality of Life, Aix Marseille University, Marseille, France
| | - Guillaume Fond
- EA 3279, CEReSS, Research Centre on Health Services and Quality of Life, Aix Marseille University, Marseille, France
| | - Pascal Auquier
- EA 3279, CEReSS, Research Centre on Health Services and Quality of Life, Aix Marseille University, Marseille, France
| | - Tham Thi Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Faculty of Nursing, Duy Tan University, Da Nang, Vietnam
| | - Carl A. Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Cyrus S. H. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Roger C. M. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
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The relationship between physical activity and depressive symptoms is domain-specific, age-dependent, and non-linear: An analysis of the Brazilian national health survey. J Psychiatr Res 2023; 159:205-212. [PMID: 36739848 DOI: 10.1016/j.jpsychires.2023.01.041] [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: 06/27/2022] [Revised: 12/20/2022] [Accepted: 01/26/2023] [Indexed: 01/30/2023]
Abstract
Although there is consistent evidence of the beneficial effects of leisure physical activity (PA) on mental health, the role of PA in the domestic, transport, and occupational domains is inconclusive. This study aimed to analyze the relationship between domain-specific PA and depressive symptoms and examine whether the association is moderated by age in a representative sample of the Brazilian population. Cross-sectional data of 89,923 (52.4% female) individuals aged ≥15 years were analyzed. Depressive symptoms were assessed using the Patient Health Questionnaire-9. Physical activity (min/week) performed in different domains (domestic, transport, occupation, and leisure) was self-reported. Generalized additive models with penalized splines were used to explore associations. Lower leisure-time PA and higher levels of PA in the domestic, occupational, and transport domains at distinct PA thresholds were associated with higher depressive symptoms. Leisure PA, even at lower levels, was associated with lower depressive symptoms compared to no PA at all. The increase in depressive symptoms as a function of occupational PA was observed only at PA levels higher than 40 h/week. Although non-leisure PA levels were related to higher depressive symptoms among the total sample, higher domestic and transport PA levels were related to lower depressive symptoms among older adults. This study provides insights into the non-linearity and age-group dependence of the relationship between domain-specific PA and depressive symptoms in a middle-income country. The evidence suggests that care should be taken on recommending PA regardless of context or domain.
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Rosario-Hernández E, Rovira-Millán LV, Merino-Soto C, Angulo-Ramos M. Review of the psychometric properties of the Patient Health Questionnaire-9 (PHQ-9) Spanish version in a sample of Puerto Rican workers. Front Psychiatry 2023; 14:1024676. [PMID: 36865076 PMCID: PMC9971011 DOI: 10.3389/fpsyt.2023.1024676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 01/03/2023] [Indexed: 02/16/2023] Open
Abstract
Background This study aimed to examine the internal structure and assess the psychometric properties of the Patient Health Questionnaire (PHQ-9) in a Puerto Rican sample of workers. This instrument is a nine-item questionnaire, which was conceptualized as a unidimensional structure; however, there are mixed results regarding this internal structure. This measure is used in the occupational health psychology context in organizations in Puerto Rico; nevertheless, there is little evidence of its psychometric properties with samples of workers. Materials and methods A total of 955 samples from two different study samples were used in this cross-sectional study design in which the PHQ-9 was used. We conducted confirmatory factor analysis, bifactor analysis, and random intercept item factor analysis to examine the internal structure of the PHQ-9. Moreover, a two-factor model was examined by randomly assigning items to the two factors. Measurement invariance across sex and the relationship with other constructs were examined. Results The best-fitted model was the bifactor model followed by the random intercept item factor. The five sets of two-factor models with items randomly assigned obtained acceptable and similar fit indices regardless of the items. Conclusion The results suggest that the PHQ-9 appears to be a reliable and valid instrument to measure depression. The more parsimonious interpretation of its scores, for now, is a unidimensional structure. Comparison across sex appears to be useful in occupational health psychology research settings since the results suggest that the PHQ-9 is invariant regarding this variable.
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Affiliation(s)
- Ernesto Rosario-Hernández
- Clinical Psychology Programs, School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, Puerto Rico
- Ponce Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico
| | | | - César Merino-Soto
- Instituto de Investigación de Psicología, Universidad de San Martín de Porres, Lima, Peru
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Valladares-Garrido MJ, León-Figueroa DA, Picón-Reátegui CK, García-Vicente A, Valladares-Garrido D, Failoc-Rojas VE, Pereira-Victorio CJ. Prevalence and Factors Associated with Eating Disorders in Military First Line of Defense against COVID-19: A Cross-Sectional Study during the Second Epidemic Wave in Peru. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2848. [PMID: 36833544 PMCID: PMC9957196 DOI: 10.3390/ijerph20042848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/31/2022] [Accepted: 11/04/2022] [Indexed: 06/18/2023]
Abstract
Few studies have evaluated eating disorders in military personnel engaged in defense activities during the COVID-19 pandemic. We aimed to determine the prevalence and factors associated with eating disorders in military personnel from Lambayeque, Peru. A secondary data analysis was performed among 510 military personnel during the second epidemic wave of COVID-19 in Peru. We used the Eating Attitudes Test (EAT-26) to assess eating disorders. We explored associations with insomnia, food insecurity, physical activity, resilience, fear to COVID-19, burnout syndrome, anxiety, depression, post-traumatic stress and selected sociodemographic variables. Eating disorders were experienced by 10.2% of participants. A higher prevalence of eating disorders was associated with having 7 to 12 months (PR: 2.97; 95% CI: 1.24-7.11) and 19 months or more (PR: 2.62; 95% CI: 1.11-6.17) working in the first line of defense against COVID-19, fear of COVID-19 (PR: 2.20; 95% CI: 1.26-3.85), burnout syndrome (PR: 3.73; 95% CI: 1.90-7.33) and post-traumatic stress (PR: 2.97; 95% CI: 1.13-7.83). A low prevalence of eating disorders was found in the military personnel. However, prevention of this problem should be focused on at-risk groups that experience mental health burdens.
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Affiliation(s)
- Mario J. Valladares-Garrido
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima 15046, Peru
- Oficina de Epidemiología, Hospital Regional Lambayeque, Chiclayo 14012, Peru
| | - Darwin A. León-Figueroa
- Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima 15013, Peru
- School of Medicine, Universidad de San Martín de Porres, Chiclayo 14012, Peru
| | | | - Abigaíl García-Vicente
- School of Medicine, Universidad Nacional de Piura, Piura 20002, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Piura (SOCIEMUNP), Piura 20002, Peru
| | - Danai Valladares-Garrido
- School of Medicine, Universidad Cesar Vallejo, Piura 20001, Peru
- Unidad de Epidemiología y Salud Ambiental, Hospital de Apoyo II Santa Rosa, Piura 20008, Peru
| | - Virgilio E. Failoc-Rojas
- Research Unit for Generation and Synthesis Evidence in Health, Universidad San Ignacio de Loyola, Lima 15024, Peru
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Self-Identification of Mental Health Problems Among Young Adults Experiencing Homelessness. Community Ment Health J 2023; 59:844-854. [PMID: 36681751 PMCID: PMC9867546 DOI: 10.1007/s10597-022-01068-9] [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: 07/01/2022] [Accepted: 12/05/2022] [Indexed: 01/22/2023]
Abstract
Young adults experiencing homelessness (YAEH) have high rates of mental health problems but low rates of mental health service use. This study examined identification of mental health problems among YAEH in seven U.S. cities and its relationship to service use. YAEH that screened positive for depression, psychological distress, or Post Traumatic Stress (n = 892) were asked whether they felt they had a mental health problem. One-third identified as having a mental health problem (35%), with 22% endorsing not sure. Multinomial logistic regression models found that older age, cisgender female or gender-expansive (compared to cisgender male), and LGBQ sexual orientation, were positively associated with self-identification and Hispanic race/ethnicity (compared to White) was negatively associated. Self-identification of a mental health problem was positively associated with use of therapy, medications, and reporting unmet needs. Interventions should target understanding mental health, through psychoeducation that reduces stigma, or should reframe conversations around wellness, reducing the need to self-identify.
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Olórtegui-Yzú A, Vega-Dienstmaier JM, Fernández-Arana A. Relationship between depression, anxiety, and perceived stress in health professionals and their perceptions about the quality of the health services in the context of COVID-19 pandemic. Brain Behav 2023; 13:e2816. [PMID: 36427250 PMCID: PMC9847603 DOI: 10.1002/brb3.2816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/11/2022] [Accepted: 10/20/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The health emergency caused by COVID-19 revealed the shortcomings of health services (HS), but little is known about how this has impacted the mental health of health professionals (HP). METHODS Data were collected through an online survey administered to HP in Lima (Peru) between May and July 2020. Instruments were applied to evaluate anxiety, depression, perceived stress (PS), and perceived quality of health services (PQHS). RESULTS A total of 507 HP completed the survey. In the multivariate analysis, younger age and female gender were related to anxiety, depression, and PS (all with p < .001). The most relevant unfavorable PQHS associated with anxiety were competence of other HP to care for HP if infected (p = .002) and support for HP or their families in the event of becoming infected (p = .001); the most relevant unfavorable PHQS associated with depression were equipment to care for HP and their families if infected (p = .003); support for HP or their families if infected (p < .001); fear of HP and/or family members being infected or dying (p = .006); and HP' recognition of their competencies (p < .001); and the most relevant unfavorable PHQS associated with PS were support for HP or their families if infected (p < .001) and instability of knowledge (p = .027). CONCLUSIONS There was an association between impaired mental health and PQHS scores among HP. This study shows the need for HP to express their concerns about how HS are supporting their safety and that of their family during health emergencies.
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Affiliation(s)
- Adriel Olórtegui-Yzú
- Universidad Nacional Mayor de San Marcos, Facultad de Medicina de San Fernando, Lima, Perú.,Instituto Nacional Cardiovascular-INCOR-EsSalud, Lima, Perú
| | - Johann M Vega-Dienstmaier
- Universidad Nacional Mayor de San Marcos, Facultad de Medicina de San Fernando, Lima, Perú.,Instituto Nacional Cardiovascular-INCOR-EsSalud, Lima, Perú
| | - Alberto Fernández-Arana
- Universidad Nacional Mayor de San Marcos, Facultad de Medicina de San Fernando, Lima, Perú.,Instituto Nacional Cardiovascular-INCOR-EsSalud, Lima, Perú
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Manrique-Millones D, García-Serna J, Castillo-Blanco R, Fernández-Ríos N, Lizarzaburu-Aguinaga DA, Parihuamán-Quinde GR, Villarreal-Zegarra D. When COVID-19 strikes mental health: a measurement analysis of reassurance seeking behavior scale in Peruvian population. Front Psychol 2023; 14:1132804. [PMID: 37138976 PMCID: PMC10151000 DOI: 10.3389/fpsyg.2023.1132804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/30/2023] [Indexed: 05/05/2023] Open
Abstract
Background The long-lasting impact of the COVID-19 pandemic cannot be overstated. To combat its dire consequences, some screening measures have been hastily developed and require robust verification to explore their adequacy across different groups. The present research study aimed to analyze measurement invariance by sociodemographic characteristics of the Coronavirus Reassurance Seeking Behavior Scale (CRSB) in Peruvian adults. Methods A total of 661 participants completed The Coronavirus Reassurance Seeking Behavior Scale (CRSB), the Coronavirus Anxiety Scale (CAS), and sociodemographic information a subgroup filled in the Patient Health Questionnaire (PHQ-9). Reliability and measurement invariance across sociodemographic characteristics were analyzed. Likewise, associations with depression and dysfunctional coronavirus anxiety were examined. Results Results showed that the single factor structure of the CRSB with correlated errors fitted the data adequately and the instrument was invariant across gender, age, and loss of a significant relative to COVID-19. In addition, significant associations with depressive symptoms and dysfunctional anxiety were found. Conclusion The findings of the present study suggest that the Coronavirus Reassurance Seeking Behaviors Scale is invariant across different sociodemographic characteristics.
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Affiliation(s)
- Denisse Manrique-Millones
- Carrera de Psicología, Universidad Científica del Sur, Lima, Peru
- *Correspondence: Denisse Manrique-Millones,
| | | | | | | | | | | | - David Villarreal-Zegarra
- Instituto Peruano de Orientación Psicológica, Lima, Peru
- South American Center for Education and Research in Public Health, Universidad Privada Norbert Wiener, Lima, Peru
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Zegarra-Rodríguez CA, Plasencia-Dueñas NR, Failoc-Rojas VE. Disparities in the prevalence of screened depression at different altitudes in Peru: A retrospective analysis of the ENDES 2019. PLoS One 2022; 17:e0278947. [PMID: 36542597 PMCID: PMC9770421 DOI: 10.1371/journal.pone.0278947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 11/24/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Depression is a public health concern, nearing 1.5 million cases and accounting for 9.7% of years lost due to disability. Several factors, including altitude, contribute to its development. Altitude has become a topic for recent research, but its association with depressive symptoms has not been fully clarified. Therefore, this study aimed to determine the association between altitude and depressive symptoms in the Peruvian population. METHODS A retrospective, cross-sectional study of the 2019 Demographic and Family Health Survey (ENDES in Spanish) was conducted. The dependent variable, depressive symptoms, was measured using the Patient Health Questionnaire (PHQ-9) and the independent variable, altitude, was categorized into: <1500 meters above sea level (masl), 1500-2499 masl and ≥2500 masl. To evaluate the association between altitude and depressive symptoms, we used Poisson regression model, constructing crude and multiple models. RESULTS Of those living at 1500 to 2499 masl and ≥2500 masl, 7.23% and 7.12% had depressive symptoms, respectively. After adjusting for confounding variables, high altitude was found to be associated with depressive symptoms (prevalence ratio adjusted (aPR): 1.38, 95% confidence interval: 1.04-1.84; aPR 1.41, 95% CI: 1.20-1.66). CONCLUSIONS A statistically significant association was found between high altitude and depressive symptoms. This may be attributable to hypobaric hypoxia that occurs at high altitudes and its effects on brain function. This study's findings should be considered to identify the population at risk and expand the coverage of preventive and therapeutic measures in high-altitude areas of Peru with poor access to health services.
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Affiliation(s)
- Cynthia Alejandra Zegarra-Rodríguez
- School of Medicine, Universidad Nacional Pedro Ruiz Gallo, Lambayeque, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional Pedro Ruiz Gallo (SOCIEM-UNPRG), Lambayeque, Peru
| | - Nahún Raphael Plasencia-Dueñas
- School of Medicine, Universidad Nacional Pedro Ruiz Gallo, Lambayeque, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional Pedro Ruiz Gallo (SOCIEM-UNPRG), Lambayeque, Peru
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Can a linking crosswalk table be applied to a different population? An independent validation study for a crosswalk between BSI depression and PROMIS depression scales. PLoS One 2022; 17:e0278232. [PMID: 36441806 PMCID: PMC9704687 DOI: 10.1371/journal.pone.0278232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 11/13/2022] [Indexed: 11/30/2022] Open
Abstract
A linking procedure establishes a "bridge" between the scores from different patient-reported outcome (PRO) instruments that measure similar constructs. After developing a linking relationship however, it is critical to evaluate whether this relationship can be generalized to different groups. Our study aims to validate a published crosswalk for score conversion between the Brief Symptom Inventory Depression subscale and the Patient-Reported Outcomes Measurement Information System Depression 8a using an independent sample. Data were from a sample of young men who have sex with men (MSM), which differs in terms of participant age, race, and ethnicity from the sample used to develop the existing crosswalk. The validity of the newly derived crosswalk was evaluated in terms of the correlation, mean difference and standard deviation between the observed and the linked scores. The two crosswalks were further compared to evaluate if the difference was within an acceptable range. More than half of the item parameters obtained from the two samples were found to overlap in their confidence intervals. Differences between each pair of scores in the two crosswalks was within three T-score points, well within the range of each crosswalk score's standard error. This study concludes that an existing crosswalk is replicable on a sample that differs from that used for crosswalk development, but future research should continue to examine the generalizability of the linked parameters and evaluate the reproducibility of this crosswalk to other populations.
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Zegarra-López AC, Florentino-Santisteban B, Flores-Romero J, Delgado-Tenorio A, Cernades-Ames A. A Cross-Sectional Study on the Prevalence of Depressive Symptoms and Its Associated Sociodemographic Factors in Peru during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14240. [PMID: 36361118 PMCID: PMC9654240 DOI: 10.3390/ijerph192114240] [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: 09/05/2022] [Revised: 10/21/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
The present study aims to analyze the prevalence of depressive symptoms and its sociodemographic-associated factors in Peruvian adults. Data was extracted from a nation-wide representative survey in which depression symptoms were measured with the PHQ-9 and sociodemographic information was extracted from household data. Depression severity rates were estimated for each symptom, and responses were modeled through the Rating Scale Model to obtain a depression measure used as dependent variable on a Generalized Mixed Linear Model. The most frequent depression symptoms were emotional, such as discouragement, sad mood, hopelessness, and lack of pleasure when doing activities. Our model showed that, after controlling the effects of all the variables considered, the most relevant predictors were gender, education level, physiographic region, age, marital status, and number of coresidents. Higher depression levels were found in women, people who did not complete higher education, participants living in the Highlands, older adults, single participants, and people living alone. Thus, interventions to promote or prevent depression severity during similar situations as the pandemic should focus on specific sociodemographic groups and their particular needs.
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Affiliation(s)
- Angel Christopher Zegarra-López
- Faculty of Psychology, Universidad de Lima, Lima 15023, Peru
- Grupo de Investigación en Psicología, Bienestar y Sociedad, Instituto de Investigación Científica, Universidad de Lima, Lima 15023, Peru
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Soriano-Moreno AN, Flores EC, Hartinger SM, Mallma CY, Diaz AA, Gianella GE, Galvez-Buccollini JA, Coico-Lama AH, Malaga G, Fajardo E, Paredes-Angeles R, Otazú-Alfaro S, Lescano AG, Checkley W. Home-Based Respiratory Physiotherapy and Telephone-Based Psychological Support for COVID-19 Survivors in Peru: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e36001. [PMID: 36108135 PMCID: PMC9595592 DOI: 10.2196/36001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 07/19/2022] [Accepted: 08/02/2022] [Indexed: 01/26/2023] Open
Abstract
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.
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Affiliation(s)
- Anderson N Soriano-Moreno
- Pulmonary Training Program in Peru, Universidad Peruana Cayetano Heredia, Lima, Peru
- Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, MD, United States
- Clima, Latin American Center of Excellence on Climate Change and Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Elaine C Flores
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Center for Innovation in Global Health, Stanford University, Palo Alto, CA, United States
| | - Stella M Hartinger
- Pulmonary Training Program in Peru, Universidad Peruana Cayetano Heredia, Lima, Peru
- Clima, Latin American Center of Excellence on Climate Change and Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Claudia Y Mallma
- Escuela Profesional de Tecnología Médica, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Arnold A Diaz
- Department of Physical Medicine and Rehabilitation, Hospital EsSalud Alberto Sabogal Sologuren, Lima, Peru
- Emerge, Climate Change and Emerging Disease Research Unit, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Gonzalo E Gianella
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Abdiel H Coico-Lama
- Emerge, Climate Change and Emerging Disease Research Unit, Universidad Peruana Cayetano Heredia, Lima, Peru
- Clinical and Epidemiological Research Unit, School of Medicine, Universidad Peruana Unión, Lima, Peru
| | - German Malaga
- Department of Medicine, Hospital Nacional Cayetano Heredia, Lima, Peru
| | - Eufemia Fajardo
- Department of Physical Medicine and Rehabilitation, Hospital Nacional Cayetano Heredia, Lima, Peru
| | - Rubí Paredes-Angeles
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Grupo de Estudios Avances en Medición Psicológica, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Sharlyn Otazú-Alfaro
- Mental Health Research Unit, Instituto Peruano de Orientación Psicológica, Lima, Peru
| | - Andres G Lescano
- Pulmonary Training Program in Peru, Universidad Peruana Cayetano Heredia, Lima, Peru
- Clima, Latin American Center of Excellence on Climate Change and Health, Universidad Peruana Cayetano Heredia, Lima, Peru
- Emerge, Climate Change and Emerging Disease Research Unit, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - William Checkley
- Pulmonary Training Program in Peru, Universidad Peruana Cayetano Heredia, Lima, Peru
- Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, MD, United States
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
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Villarreal-Zegarra D, Paredes-Angeles R, Mayo-Puchoc N, Vilela-Estada AL, Copez-Lonzoy A, Huarcaya-Victoria J. An explanatory model of depressive symptoms from anxiety, post-traumatic stress, somatic symptoms, and symptom perception: the potential role of inflammatory markers in hospitalized COVID-19 patients. BMC Psychiatry 2022; 22:638. [PMID: 36210450 PMCID: PMC9548421 DOI: 10.1186/s12888-022-04277-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 08/05/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The context of the COVID-19 pandemic has harmed the mental health of the population, increasing the incidence of mental health problems such as depression, especially in those who have had COVID-19. Our study puts forward an explanatory model of depressive symptoms based on subjective psychological factors in those hospitalized for COVID-19 with and without biological markers (i.e., inflammatory markers). Therefore, we aim to evaluate the hypotheses proposed in the model to predict the presence of depressive symptoms. METHOD We conducted a cross-sectional study, using a simple random sampling. Data from 277 hospitalized patients with COVID-19 in Lima-Peru, were collected to assess mental health variables (i.e., depressive, anxiety, post-traumatic stress, and somatic symptoms), self-perception of COVID-19 related symptoms, and neutrophil/lymphocyte ratio (NLR) such as inflammatory marker. We performed a structural equation modeling analysis to evaluate a predictive model of depressive symptoms. RESULTS The results showed a prevalence of depressive symptoms (11.2%), anxiety symptoms (7.9%), somatic symptoms (2.2%), and symptoms of post-traumatic stress (6.1%) in the overall sample. No association was found between the prevalence of these mental health problems among individuals with and without severe inflammatory response. The mental health indicators with the highest prevalence were sleep problems (48%), low energy (47.7%), nervousness (48.77%), worry (47.7%), irritability (43.7%) and back pain (52%) in the overall sample. The model proposed to explain depressive symptoms was able to explain more than 83.7% of the variance and presented good goodness-of-fit indices. Also, a different performance between the proposed model was found between those with and without severe inflammatory response. This difference was mainly found in the relationship between anxiety and post-traumatic stress symptoms, and between the perception of COVID-19 related symptoms and somatic symptoms. CONCLUSIONS Results demonstrated that our model of mental health variables may explain depressive symptoms in hospitalized patients of COVID-19 from a third-level hospital in Peru. In the model, perception of symptoms influences somatic symptoms, which impact both anxiety symptoms and symptoms of post-traumatic stress. Thus, anxiety symptoms could directly influence depressive symptoms or through symptoms of post-traumatic stress. Our findings could be useful to decision-makers for the prevention of depression, used to inform the creation of screening tools (i.e., perception of symptoms, somatic and anxiety symptoms) to identify vulnerable patients to depression.
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Affiliation(s)
- David Villarreal-Zegarra
- grid.441978.70000 0004 0396 3283Escuela de Medicina, Universidad César Vallejo, Trujillo, Peru ,Instituto Peruano de Orientación Psicológica, Lima, Peru
| | | | | | | | - Anthony Copez-Lonzoy
- Instituto Peruano de Orientación Psicológica, Lima, Peru ,grid.441908.00000 0001 1969 0652Unidad de Investigación en Bibliometría, Universidad San Ignacio de Loyola, Lima, Peru ,PSYCOPERU Peruvian Research Institute of Educational and Social Psychology, Lima, Peru
| | - Jeff Huarcaya-Victoria
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Filial Ica, Peru. .,Departamento de Psiquiatría, Servicio de Psiquiatría de Adultos, Unidad de Psiquiatría de Enlace, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú.
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Polak M, Nowicki GJ, Naylor K, Piekarski R, Ślusarska B. The Prevalence of Depression Symptoms and Their Socioeconomic and Health Predictors in a Local Community with a High Deprivation: A Cross-Sectional Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811797. [PMID: 36142069 PMCID: PMC9517619 DOI: 10.3390/ijerph191811797] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/09/2022] [Accepted: 09/16/2022] [Indexed: 06/01/2023]
Abstract
Depression is a heterogeneous and etiologically complex psychiatric syndrome thatshows a strong sexual dimorphism and often impacts people with a low socioeconomic status (SES). The aim of the study was to estimate the occurrence of depression symptoms in a local community with a high deprivation rate, the example being the inhabitants of the JanówLubelski County in eastern Poland. A cross-sectional study was carried out on 3752 people aged between 35 and 64. The prevalence of depression symptoms was assessed using the Patient Health Questionnaire-9 (PHQ-9) scale. In the screening for depression symptoms in the entire population we studied, the risk of depression symptoms was 16.1% (n = 605), with women having a significantly higher mean score than men (p < 0.001). Significant predictors associated with the achievement of 10 points and more in the PHQ-9 assessment in the case of women and men were: living alone, education and having comorbidities. Moreover, female participants living in rural areas were significantly more likely to exhibit depression symptoms, whereas smoking was a significant predictor of depressive symptoms in men. It was observed that in the case of obese women, the chance of being in the higher category of the PHQ-9 assessment was 1.41 times higher than in women with normal body weight. However, in the case of men, an increase in age by one year increased the chance of being in a higher category by 1.02 times. Moreover, the odds of falling into a higher category, as assessed by the PHQ-9 questionnaire, among men who drink alcohol more than once a week was 1.7 times higher than in men who do not drink or consume alcohol occasionally. Summarising the results of studies conducted in a local community characterised by a high deprivation rate, socioeconomic and health variables related to SES significantly impacted the incidence of depression, but they differ in terms of gender.
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Affiliation(s)
- Maciej Polak
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Skawińska 8 Str., PL-31-066 Krakow, Poland
| | - Grzegorz Józef Nowicki
- Department of Family and Geriatric Nursing, Medical University of Lublin, Staszica 6 Str., PL-20-081 Lublin, Poland
| | - Katarzyna Naylor
- Department of Didactics and Medical Simulation, Medical University of Lublin, Chodźki 4 Str., PL-20-093 Lublin, Poland
| | - Robert Piekarski
- Diabetology with Endocrine—Metabolic Laboratory, Department of Paediatric Endocrinology, Medical University of Lublin, Gębali 6 Str., 20-093 Lublin, Poland
| | - Barbara Ślusarska
- Department of Family and Geriatric Nursing, Medical University of Lublin, Staszica 6 Str., PL-20-081 Lublin, Poland
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Travezaño-Cabrera A, Vilca LW, Quiroz-Becerra J, Huerta SL, Delgado-Vallejos R, Caycho-Rodríguez T. Meaning of life questionnaire (MLQ) in peruvian undergraduate students: study of its psychometric properties from the perspective of classical test theory (CTT). BMC Psychol 2022; 10:206. [PMID: 36002892 PMCID: PMC9400558 DOI: 10.1186/s40359-022-00913-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/16/2022] [Indexed: 11/24/2022] Open
Abstract
Background The study of the meaning of life is essential since it plays a protective role in the mental health of university students. However, no studies have shown the adequate psychometric functioning of the MLQ in Latin American university students. For this reason, this research aims to evaluate the internal structure using CTT models, obtain evidence of validity based on the relationship with other variables, perform factorial invariance according to gender, and estimate the reliability of the MLQ. Methods A sample of 581 Peruvian undergraduate students of both sexes (29.5% men and 70.5% women) between the ages of 18 and 35 (M = 22.6; SD = 3.3) was collected. Along with the MLQ, other instruments were applied to measure satisfaction with life (SWLS), subjective well-being (WBI), and depression (PHQ-9). Results In the present study was evidenced that the model of two related factors of nine items presents better adjustment indices (RMSEA = .075; SRMR = .059; CFI = .97; TLI = .96) compared to other models. Also, it was shown that the factorial structure of the MLQ is strictly invariant for the group of men and women. It was also shown that the presence of meaning was positively related to satisfaction with life (.63) and well-being (.60) and negatively to depression (− .56). In contrast, the search for meaning was not significantly related to life satisfaction (− .05) and well-being (− .07); but yes, to depression (.19). Conclusion It is concluded that the MLQ from the perspective of CTT has shown adequate evidence of reliability and validity. Therefore, it could be used in future studies and evaluation and intervention processes. In addition, the study provides the first evidence of the psychometric functioning of the scale in university students from Latin America.
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Affiliation(s)
| | - Lindsey W Vilca
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima, Perú.
| | | | - Samy L Huerta
- Departamento de Psicología, Universidad Peruana Unión, Lima, Perú
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Fernandez-Canani MA, Burga-Cachay SC, Valladares-Garrido MJ. Association between Family Dysfunction and Post-Traumatic Stress Disorder in School Students during the Second COVID-19 Epidemic Wave in Peru. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159343. [PMID: 35954701 PMCID: PMC9367873 DOI: 10.3390/ijerph19159343] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/23/2022] [Accepted: 07/27/2022] [Indexed: 02/01/2023]
Abstract
Although the effect of the COVID-19 pandemic on children and adolescents’ mental health has been studied, there is still scarce evidence of the influence of nuclear family on the development of post-traumatic stress disorder (PTSD). This study aimed to determine the association between family dysfunction and PTSD in Peruvian high-school students during the COVID-19 pandemic. A cross-sectional study was conducted using a virtual survey administered to 562 high-school students in three schools in Chiclayo, Peru. The dependent variable was PTSD, which was measured with the Child PTSD Symptom Scale. Family dysfunction was the main independent variable, measured with the Family APGAR Questionnaire. Prevalence ratios (PR) and 95% confidence intervals (95% CI) were estimated with generalized linear models. Most of the students were female (88.3%) and the average age was 14.4 years. We found that 21.4% showed severe family dysfunction and 60.3% had PTSD. Students with mild and moderate family dysfunction had 37% (PR: 1.37; 95% CI: 1.14–1.65) and 26% (PR: 1.26; 95% CI: 1.04–1.54) higher PTSD prevalence, respectively. In conclusion, family dysfunction may influence the development of PTSD in adolescents. This study suggests the importance to develop a healthy family environment to help adolescents face critical situations experienced during the pandemic.
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Affiliation(s)
- Maria A. Fernandez-Canani
- School of Medicine, Universidad de San Martín de Porres, Chiclayo 14012, Peru; (M.A.F.-C.); (S.C.B.-C.)
| | - Stefany C. Burga-Cachay
- School of Medicine, Universidad de San Martín de Porres, Chiclayo 14012, Peru; (M.A.F.-C.); (S.C.B.-C.)
| | - Mario J. Valladares-Garrido
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima 15046, Peru
- Hospital Regional Lambayeque, Chiclayo 14012, Peru
- Correspondence:
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Mental Health Disturbance after a Major Earthquake in Northern Peru: A Preliminary, Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148357. [PMID: 35886205 PMCID: PMC9319911 DOI: 10.3390/ijerph19148357] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 11/17/2022]
Abstract
Little has been studied in Peru on the mental health repercussions after a major earthquake. We aimed to explore the factors associated with depressive and anxiety symptoms in people who experienced a 6.1 magnitude earthquake in Piura, Peru, on 30 July 2021. A preliminary cross-sectional study was conducted in the general population between August–September 2021. An online questionnaire was provided using PHQ-9, GAD-7, and other relevant measures. Generalized linear models were applied. Of the 177 participants, the median age was 22 years, the majority were female (56%), and many experienced depressive (52%) or anxiety symptoms (52%). Presence of depressive symptoms was associated with a personal history of mental disorder, moderate housing damage, social/material support from politicians, moderate food insecurity, and insomnia. Presence of anxiety symptoms was associated with physical injury caused by the earthquake, mild food insecurity, and insomnia. The development of depressive and anxiety symptoms following the 2021 earthquake experienced in Piura depended on multiple individual and socioeconomic factors. Additional studies should reinforce the factors identified here given the methodological limitations, such as the study design, sampling method, and sample size. This would lead to effective intervention measures to mitigate the impact of earthquakes on mental health.
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Hernández-Vásquez A, Vargas-Fernández R, Chavez-Ecos F, Mendoza-Correa I, Del Carmen Sara J. Association between maternal depression and emotion and behavior regulation in Peruvian children: a population-based study. Prev Med Rep 2022; 28:101879. [PMID: 35813400 PMCID: PMC9260607 DOI: 10.1016/j.pmedr.2022.101879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 12/01/2022] Open
Abstract
Depression is more frequent in women, affecting the early stages of child development. This study aimed to determine the association between maternal depression and self-regulation of emotions and behaviors in Peruvian children under five years. A cross-sectional analytical study of data collected by the 2019 Demographic and Family Health Survey (ENDES) was conducted. The outcome variable was emotion and behavior regulation in children aged 24 to 59 months, and exposure was the presence of depression in women aged 15 to 49 years during the 14 days prior to the survey using the Patient Health Questionnaire (PHQ-9). A generalized linear model of the binomial family was used for reporting crude prevalence ratios and adjusted. The overall prevalence of children who did not self-regulate their emotions and behaviors was 68.8%, while 3.8% of the mothers had moderate depressive symptoms and 2.2% severe symptoms. Regarding the association of interest, moderate and severe depressive symptoms of mothers decreased the probability of children regulating emotions and behaviors in the first model, whereas in the second model, an association was only found with severe depressive symptoms. In conclusion, children of mothers with moderate and severe depressive symptoms had a lower probability of self-regulating their emotions and behaviors. Therefore, it is necessary to develop maternal education, nutritional and social support programs and mental health strategies from the first level of care aimed at reducing social, economic and child factors to reduce the risk of depression in mothers and low early childhood development, which could reduce the risk of developing mental health disorders in adolescence and adulthood.
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Arenas E, Teruel G, Gaitán-Rossi P. Time and gender measurement invariance in the modified Calderon depression scale. Health Qual Life Outcomes 2022; 20:100. [PMID: 35752851 PMCID: PMC9233789 DOI: 10.1186/s12955-022-02007-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/08/2022] [Indexed: 11/21/2022] Open
Abstract
Background Assessing change and comparing groups requires high quality and invariant scales. However, there is limited evidence of simultaneous longitudinal and gender measurement invariance for depression scales. This evidence is even more scant with long-established panel studies from low and middle-income countries. Methods In this paper, we used three waves (years 2002, 2005, and 2009) of a nationally representative panel study to examine the psychometric properties of the modified Calderon Depression Scale (CAL-DM)—a one-item exclusion of a depression scale designed for a population residing in a middle-income country (i.e., Mexico). Our analytical sample included 16,868 participants: 7,696 men and 9,172 women. Using Confirmatory Factor Analysis (CFA), we first examined overall fit in each wave, and then we tested time, gender, and time-gender measurement invariance across three waves. We also estimated and compared depression score means by gender and time. Finally, we examined the association between depression scores and self-rated health. Results Our analyses indicated the CAL-DM is a robust scale, suitable for time, gender, and time by gender comparisons. Mean comparisons exemplified how the scale can be used as a latent variable or a summative score. Women have higher depression scores than men and the gap is narrowing from 3.4 in 2002 to 2.5 in 2009. Conclusions The CAL-DM is a reliable instrument to measure depression in the Mexican general population that can be used for epidemiological research. Our results will contribute to a burgeoning line of research that examines the social determinants of depression, and the risk factors associated with different individuals’ depression trajectories over the life course. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-022-02007-8.
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Affiliation(s)
- Erika Arenas
- Department of Sociology, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Graciela Teruel
- Instituto de Investigaciones Para El Desarrollo Con Equidad (EQUIDE), Universidad Iberoamericana, Mexico City, Mexico
| | - Pablo Gaitán-Rossi
- Instituto de Investigaciones Para El Desarrollo Con Equidad (EQUIDE), Universidad Iberoamericana, Mexico City, Mexico.
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Validity and reliability of the Patient Health Questionnaire scale (PHQ-9) among university students of Bangladesh. PLoS One 2022; 17:e0269634. [PMID: 35675375 PMCID: PMC9176811 DOI: 10.1371/journal.pone.0269634] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 05/24/2022] [Indexed: 01/05/2023] Open
Abstract
This study investigated the reliability and factorial validity of Patient Health Questionnaire-9 (PHQ-9) in the context of university students in Bangladesh. The research aimed to assess whether the original one-dimensional model or a model containing both somatic and cognitive-emotional factors is appropriate in the case of a sample of university students. A repeated cross-sectional survey design based on convenience sampling was used to collect data from 677 university students from both public and private universities. The factor structure of the PHQ-9 was assessed using confirmatory factor analysis (CFA). Measurement invariances were assessed across gender, type of university, level of education and victim of domestic violence. Its convergent validity was determined by investigating its correlations with Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire Anxiety-Depression Scale (PHQ-ADS). Results showed excellent reliability of PHQ-9 as measured by both Cronbach's α and McDonald's ω. CFA suggested that a modified one-factor model where the error variances between item-3 ('sleeping difficulties') and item-6 ('feeling as a failure'), item-6 and item-9 ('suicidal thoughts'), item-4 ('feeling tired') and item-9, item-3 and item-9 were allowed to covary is appropriate for the sample. This model provided high values of comparative fit index (CFI), goodness of fit index (GFI), and Tucker Lewis Index (TLI), low value of standardized root mean square residual (SRMR) and a non-significant root mean square error of approximation (RMSEA) as well as a high Factor Determinacy Score Coefficient. Correlation between PHQ-9 and GAD-7 was 0.751 and 0.934 between PHQ-9 and PHQ-ADS. Finally, the model is strictly invariant across gender and university type. Overall, the study provided support for modified unidimensional structure for PHQ-9 and showed high internal consistency along with good convergent validity.
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Spanish version of Jenkins Sleep Scale in physicians and nurses: psychometric properties from a Peruvian nationally representative sample. J Psychosom Res 2022; 157:110759. [PMID: 35358746 DOI: 10.1016/j.jpsychores.2022.110759] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 02/02/2022] [Accepted: 02/05/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate the psychometric properties of the Spanish version of Jenkins Sleep Scale with 4 items (JSS-4) of the Peruvian health system's (PHS) nurses and physicians. METHODS We carried out a psychometric study based on secondary analysis in a sample from a nationally representative survey that used acomplex sampling design. The participants were physicians and nurses aged 18-65 years, working in PHS private and public facilities, who have fulfilled all JSS-4 items. We performed a confirmatory factor analysis. Reliability was evaluated via two estimates - classic alpha (α) and categorical omega (ω) coefficients. Also, we tested the invariance across groups of variables. The convergent validity was evaluated based on the relation between JSS-4 and PHQ-2 using Pearson's correlation coefficient and effect size (Cohen's d). Also, we designed normative values based on percentiles. RESULTS We included 2100 physicians and 2826 nurses in the analysis. We observed that the unidimensional model has adequate goodness-of-fit indices and values of α and ω coefficients. No measurement invariance was found between the groups of professionals and age groups; however, invariance was achieved between sex, monthly income, work-related illness, and chronic illness groups. Regarding the relation with other variables, the JSS-4 has a small correlation with PHQ-2. Also, profession and age-specific normative values were proposed. CONCLUSION JSS-4 Spanish version has adequate psychometric properties in PHS nurses and physicians.
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Krüger-Malpartida H, Arevalo-Flores M, Anculle-Arauco V, Dancuart-Mendoza M, Pedraz-Petrozzi B. [Medical conditions, symptoms of anxiety, and depression during the COVID-19 pandemic in a population sample of Lima, Peru]. REVISTA COLOMBIANA DE PSIQUIATRIA 2022:S0034-7450(22)00052-X. [PMID: 35663409 PMCID: PMC9135661 DOI: 10.1016/j.rcp.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 04/26/2022] [Indexed: 11/30/2022]
Abstract
Introduction: This study aims to determine differences between the number of underlying medical conditions, depression, and anxiety, when controlling for the covariates of age, sex, and completed education.Methods: Participants (n=484) indicated the number of medical conditions present during the survey, also including the PHQ-9 and GAD-7, to assess depression and anxiety, respectively.Results: Differences were found between groups of medical conditions and the combined values of PHQ-9 and GAD-7 after controlling for the covariates mentioned above (F4,954=5.78; Wilks' Λ=0.95; P<0.0005). The univariate tests showed differences for PHQ-9 (F2,478=8.70; P<0.0005) and GAD-7 (F2,478=11.16; P<0.0005) between the 3 groups. Finally, post-hoc analysis showed differences between participants with one medical condition and with no medical condition (PHQ-9: MD=1.82; 95%CI, 0.25-3.40; GAD-7: MD=1.73; 95%CI, 0.55-2.91), and between participants with more than one medical condition and participants with no medical condition (PHQ-9: MD=3.10; 95%CI, 1.11-5.10; GAD-7: MD=2.46; 95%CI, 0.97-3.95).Conclusions: Our results suggest that people who had a medical condition during the COVID-19 pandemic were more prone to developing severe symptoms of anxiety and depression.
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Affiliation(s)
| | - Martin Arevalo-Flores
- Departmento de Psiquiatría, Facultad de Medicina, Universidad Cayetano Heredia, Lima, Perú
- Servicio de Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú
| | - Victor Anculle-Arauco
- Departmento de Psiquiatría, Facultad de Medicina, Universidad Cayetano Heredia, Lima, Perú
- Servicio de Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú
| | - Mauricio Dancuart-Mendoza
- Departmento de Psiquiatría, Facultad de Medicina, Universidad Cayetano Heredia, Lima, Perú
- Servicio de Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú
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López-Guerra VM, López-Núñez C, Vaca-Gallegos SL, Torres-Carrión PV. Psychometric Properties and Factor Structure of the Patient Health Questionnaire-9 as a Screening Tool for Depression Among Ecuadorian College Students. Front Psychol 2022; 13:813894. [PMID: 35572338 PMCID: PMC9105228 DOI: 10.3389/fpsyg.2022.813894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 04/12/2022] [Indexed: 12/26/2022] Open
Abstract
Background The Patient Health Questionnaire-9 (PHQ-9) is the most well-known self-report measure to screen for depressive symptomatology, although discerning which is the factor structure that represents the best fit remains a challenge. Objective The aim of this study was to analyze the psychometric properties and factorial structure of the Spanish version of the PHQ-9 in a large sample of Ecuadorian college students. Methods A total of 5,394 students (M = 22.03 years; SD = 3.05; 54.8% female) from three Ecuadorian universities were surveyed using a computerized questionnaire within a 4-week assessment period. The PHQ-9 was tested for factorial structure, reliability, and correlations with other mental health-related measures. Results The hierarchical model that included a general factor and three nested factors had a better fit, and such a hierarchical structure remained invariant across sex and age. Total omega value (ω) was 0.90 for the total scale and hierarchical omega values (ωh) were 0.68 for the general factor, as well as 0.34, 0.38, and 0.44 for the respective nested factors (somatic, cognitive/affective, concentration/motor). Moreover, PHQ-9 scores were significantly higher among women, although effect sizes of comparison of those sex differences were very small. Finally, the PHQ-9 scores correlated with multiple mental health indicators (psychological inflexibility, loneliness, stress, and satisfaction with life). Discussion The Spanish version of the PHQ-9 showed good psychometric properties among Ecuadorian college students. The hierarchical structure showed the best fit for the data, including not only a dominant general factor, but also the somatic, cognitive/affective and concentration/motor subcomponents. In conclusion, the PHQ-9 tool seems to represent an easy-to-implement screening questionnaire to design preventive programs for those Ecuadorian college students at risk of developing depressive disorders.
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Affiliation(s)
| | - Carla López-Núñez
- Department of Personality, Assessment and Psychological Treatments, School of Psychology, University of Seville, Seville, Spain
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Huarcaya-Victoria J, Villarreal-Rao B, Luna M, Rojas-Mendoza W, Alarcon-Ruiz CA, Villarreal-Zegarra D, Vilela-Estrada AL, Ramírez S. Factors Associated with Mental Health Outcomes in Hospital Workers during the COVID-19 Pandemic: A Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095346. [PMID: 35564741 PMCID: PMC9103531 DOI: 10.3390/ijerph19095346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 11/30/2022]
Abstract
Background: We investigated some of the factors associated with depression, perceived stress, and anxiety in clinical and nonclinical healthcare workers of two hospitals. Methods: A mixed-methods approach was used. The sample included clinical (physicians, nurses, and others) and nonclinical (security and cleaning staff) healthcare workers of two tertiary hospitals in Peru. Participants completed an online self-survey. In the qualitative analysis, data were subjected to thematic analysis. Results: We analyzed data from 613 participants, of which 8.6%, 9.0%, and 78.2% had moderate-to-severe anxiety, depression, and perceived stress, respectively. Having a previous mental health problem, being concerned about losing one’s job, having at least two COVID-19 symptoms in the preceding two weeks, and being afraid of infecting family members increased the prevalence of experiencing moderate-to-severe depression and anxiety. The qualitative analysis allowed us to identify five recurring factors that caused a negative impact on workers’ lives during the pandemic: emotional distress linked to hospital experiences of suffering and death, modification of routines, fear of COVID-19, exacerbation of mental disorders, and physical problems associated with emotional distress. Conclusions: Clinical and nonclinical healthcare workers in Peru have experienced depression, anxiety, and stress during the COVID-19 pandemic. Future research and interventions are necessary to improve psychological support for hospital workers.
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Affiliation(s)
- Jeff Huarcaya-Victoria
- Departamento de Psiquiatría, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima 15033, Peru; (B.V.-R.); (M.L.)
- Correspondence:
| | - Beltran Villarreal-Rao
- Departamento de Psiquiatría, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima 15033, Peru; (B.V.-R.); (M.L.)
| | - Matilde Luna
- Departamento de Psiquiatría, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima 15033, Peru; (B.V.-R.); (M.L.)
| | - Wendoline Rojas-Mendoza
- Departamento de Salud Mental, Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima 15072, Peru;
| | | | - David Villarreal-Zegarra
- Dirección de Investigación, Desarrollo e Innovación, Instituto Peruano de Orientación Psicológica, Lima 15046, Peru; (D.V.-Z.); (A.L.V.-E.)
| | - Ana L. Vilela-Estrada
- Dirección de Investigación, Desarrollo e Innovación, Instituto Peruano de Orientación Psicológica, Lima 15046, Peru; (D.V.-Z.); (A.L.V.-E.)
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Huarcaya-Victoria J, Podestá A, Rojas W. Factors Associated with Distress Among Medical Staff During the Initial Phase of the COVID-19 Pandemic in Peru. Int J Ment Health Addict 2022; 21:1-10. [PMID: 35342378 PMCID: PMC8939394 DOI: 10.1007/s11469-022-00804-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/08/2022] [Indexed: 11/04/2022] Open
Abstract
The current COVID-19 pandemic affects the mental health of medical staff. Our objective was to evaluate the factors that are associated with the distress of physicians in two general hospitals in Lima, Peru. A cross-sectional correlational survey study was carried out. Physicians completed The Impact of Event Scale-Revised-22 (IES-R), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7). A total of 310 physicians completed the survey, 36.5% of whom reported distress symptoms. Higher levels of distress were reached by women, by those with a prior psychiatric diagnosis, by those who considered that the hospital does not provide adequate personal protective equipment, and by those who perceived stigma from family members. Multiple regression analysis showed that there is a correlation between distress symptoms and anxiety symptoms, (B = 0.509), depressive symptoms (B = 0.305), the total hours/week worked in the Emergency Department (B=-0.142), and the stigma perception (B = 0.096). Early intervention programs must be developed to support medical staff members exposed to severe distress situations such as the current viral pandemic.
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Affiliation(s)
- Jeff Huarcaya-Victoria
- Departamento de Psiquiatría, Servicio de Psiquiatría de Adultos, Unidad de Psiquiatría de Enlace, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Av. Grau 800, Cercado de Lima, Perú
- Escuela Profesional de Medicina Humana, Uniersidad Privada San Juan Bautista, Ica, Perú
| | - Angela Podestá
- Departamento de Psiquiatría, Servicio de Psiquiatría de Adultos, Unidad de Psiquiatría de Enlace, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Av. Grau 800, Cercado de Lima, Perú
| | - Wendoline Rojas
- Departamento de Salud Mental, Servicio de Emergencia Psiquiátrica, Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima, Perú
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Figueroa-Quiñones J, Cjuno J, Machay-Pak D, Ipanaqué-Zapata M. Quality of Life and Depressive Symptoms Among Peruvian University Students During the COVID-19 Pandemic. Front Psychol 2022; 13:781561. [PMID: 35282184 PMCID: PMC8904923 DOI: 10.3389/fpsyg.2022.781561] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 01/13/2022] [Indexed: 12/11/2022] Open
Abstract
Objective To determine the factors associated with quality of life and depressive symptoms in Peruvian university students during the COVID-19 pandemic. Methods Multicentre study in 1,634 students recruited by convenience sampling. The quality of life (QoL) was assessed with the European Quality of Life-5 Dimensions at three levels (EQ-5D-3L) and depressive symptoms with the Patient Health Questionnaire-9 (PHQ-9). To assess factors associated with QoL and depressive symptoms, linear regressions and fitted regressions were used, with robust coefficients of variance information (β). Results A 345 (21.1%) reported problems in performing daily activities, 544 (33.3%) reported pain and discomfort, 772 (47.2%) were moderately/very anxious or depressed. Furthermore, 207 (12.7%) had moderate-severe and severe depressive symptoms. Men reported better QoL than women (β: 3.2; 95% CI: 1.1, 5.4; p = 0.004) and fewer depressive symptoms (β: −0.7; 95% CI: −1.3, −0.2; p = 0.011). Ayacucho’s residents had more depressive symptoms than Ancash’s residents (β: 0.8; 95% CI: 0.1, 1.5; p = 0.022) and Piura’s residents had fewer depressive symptoms than Ancash’s residents (β: −1.195% CI: −1.8, −0.3, p = 0.005). Students who left home during quarantine reported more depressive symptoms (β: 0.7, 95% CI: 0.2, 1.2, p = 0.006). Conclusion Problems performing daily activities, pain and discomfort, as well as mild to severe depressive symptoms were found in more than three-quarters of the sample. Authorities could consider depression care to improve quality of life in regions where high rates of infection occurred during the pandemic.
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Affiliation(s)
- Joel Figueroa-Quiñones
- Instituto de Investigación, Capacitación y Desarrollo Psicosocial y Educativo: PSYCOPERU, Lima, Peru
| | - Julio Cjuno
- Escuela Profesional de Psicología, Universidad Peruana Unión, Lima, Peru.,Red Latinoamericana de Salud Mental en Pueblos Originarios, Lima, Peru
| | - Daniel Machay-Pak
- Instituto de Investigación, Capacitación y Desarrollo Psicosocial y Educativo: PSYCOPERU, Lima, Peru
| | - Miguel Ipanaqué-Zapata
- Instituto de Investigación, Capacitación y Desarrollo Psicosocial y Educativo: PSYCOPERU, Lima, Peru
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Crisol-Deza D, Poma-Ramírez D, Pacherres-López A, Noriega-Baella C, Villanueva-Zúñiga L, Salvador-Carrillo J, Huarcaya-Victoria J. Factors associated with suicidal ideation among medical students during the initial phase of the COVID-19 pandemic in Peru: A multicenter study. DEATH STUDIES 2022; 47:183-191. [PMID: 35201957 DOI: 10.1080/07481187.2022.2042752] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
We aimed to describe the prevalence and factors associated with suicidal ideation in a sample of 1238 medical students from different medical schools in Peru based on question 9 of the Patient Health Questionnaire (PHQ-9). Our results revealed that 17.9% of the participants had suicidal ideation. Furthermore, using logistic regression, we found that not practicing any religion, the presence of clinically significant depression, and the presence of clinically significant anxiety were statistically related to the presence of suicidal ideation. Our results indicate that suicidal ideation was highly prevalent in the sample of medical students studied.
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Affiliation(s)
- Diego Crisol-Deza
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Perú
- Red de Eficacia Clínica y Sanitaria, REDECS, Lima, Perú
| | - Diana Poma-Ramírez
- Sociedad Científica de Estudiantes de Medicina de la Universidad Privada San Juan Bautista (SOCIEM - UPSJB), Lima, Perú
| | - Andrés Pacherres-López
- Centro de Investigación en Educación Médica, Facultad de Medicina Humana, Universidad de San Martín de Porres, Lima, Perú
| | | | | | - José Salvador-Carrillo
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Filial Chincha, Perú
| | - Jeff Huarcaya-Victoria
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Perú
- Departamento de Psiquiatría, Servicio de Psiquiatría de Adultos, Unidad de Psiquiatría de Enlace, Hospital Nacional Guillermo Almenara Irigoyen, Seguro Social de Salud EsSalud, Lima, Perú
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Hernández-Vásquez A, Vargas-Fernández R, Rojas-Roque C, Gamboa-Unsihuay JE. Association between altitude and depression in Peru: An 8-year pooled analysis of population-based surveys. J Affect Disord 2022; 299:536-544. [PMID: 34942223 DOI: 10.1016/j.jad.2021.12.059] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/18/2021] [Accepted: 12/18/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND In high altitude regions, people experience biological, inflammatory and brain structure changes that increase the risk of depressive symptoms. The aim of this study was to determine the association between altitude and depressive symptoms in the Peruvian population, adjusting by demographic, socioeconomic and exposure to health risk factors. METHODS We performed a cross-sectional analytical study of data collected annually by the Demographic and Family Health Survey during the period 2013-2020. The presence of depressive symptoms during the last 14 days prior to the survey were measured using scores obtained from the Patient Health Questionnaire-9 (PHQ-9). A generalized linear model (GLM) of gamma family and log link function was used to report the crude and adjusted β coefficients. A quantile regression model was performed as a sensitivity analysis. RESULTS Data from a total of 215,409 participants were included. After adjusting for demographic, socioeconomic and health risk exposures, the GLM showed that an increase in every 100 m of altitude of residence was positively and significantly associated with the depressive symptoms score (β=0•01 [95% confidence interval: 0•01-0•01]). LIMITATIONS The length of residence in high altitude areas of the population included cannot be established, requiring future research to determine if the results of the present study are similar in native people or permanent residents of high altitude regions. CONCLUSIONS Altitude was positively associated with depressive symptom scores. Our results will allow the development of mental health interventions based on factors that increase the likelihood of depressive symptoms in high-altitudes.
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Affiliation(s)
- Akram Hernández-Vásquez
- Vicerrectorado de Investigación, Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Universidad San Ignacio de Loyola, Lima, Peru.
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