Person-centered care assessment tool with a focus on quality healthcare: a systematic review of psychometric properties

BACKGROUND

The person-centered care (PCC) approach plays a fundamental role in ensuring quality healthcare. The Person-Centered Care Assessment Tool (P-CAT) is one of the shortest and simplest tools currently available for measuring PCC. The objective of this study was to conduct a systematic review of the evidence in validation studies of the P-CAT, taking the "Standards" as a frame of reference.

METHODS

First, a systematic literature review was conducted following the PRISMA method. Second, a systematic descriptive literature review of validity tests was conducted following the "Standards" framework. The search strategy and information sources were obtained from the Cochrane, Web of Science (WoS), Scopus and PubMed databases. With regard to the eligibility criteria and selection process, a protocol was registered in PROSPERO (CRD42022335866), and articles had to meet criteria for inclusion in the systematic review.

RESULTS

A total of seven articles were included. Empirical evidence indicates that these validations offer a high number of sources related to test content, internal structure for dimensionality and internal consistency. A moderate number of sources pertain to internal structure in terms of test-retest reliability and the relationship with other variables. There is little evidence of response processes, internal structure in measurement invariance terms, and test consequences.

DISCUSSION

The various validations of the P-CAT are not framed in a structured, valid, theory-based procedural framework like the "Standards" are. This can affect clinical practice because people's health may depend on it. The findings of this study show that validation studies continue to focus on the types of validity traditionally studied and overlook interpretation of the scores in terms of their intended use.

Validity evidence for the coping strategy indicator-short version (CSI-S) among psychology students

The abbreviated measurement of coping strategies is useful for monitoring and identifying the effects of stress. The Coping strategy indicator-Short version (CSI-S, including the dimensions of seeking support, problem solving and avoidance strategies) is a new adaptation of the full version of this indicator, and additional evidence of its validity is needed. Psychology students (n = 125) from a public university in Lima, Peru, were recruited to help provide such evidence of validity in terms of internal structure, reliability and associations with other variables (perceived stress and general efficacy in cope with difficulties), which were evaluated using nonparametric item response theory procedures. Support-seeking and problem-solving items from the Mokken scale and the avoidance scale exhibited limitations. The correlations between the scales were moderate or low and exhibited theoretical consistency, and the relationship with perceived stress highlighted the predictive capacity of avoidance and problem-solving strategies. In general, the CSI-S exhibits suitable psychometric properties; however, the avoidance score requires further examination or reconstruction of its items.

Health-Related, Social and Cognitive Factors Explaining Gambling Addiction

BACKGROUND

Gambling addiction was the first addictive behavior not related to substance use that was recognized by the DSM-5. It shares diagnostics and comorbidity with other addictions. Extensive studies have investigated the clinical variables involved, but there have been fewer studies of related cognitive and social variables. In this research, an integrative model was developed to advance the understanding of gambling addiction, and an explanatory model was created based on the concept of cognitive distortions.

METHODS

The sample comprised 258 university students (59.5% women) with a mean age of 20.95 years (SD = 2.19). A series of questionnaires were administered to measure gambling addiction, depression, coping with stress, prosocial behavior, susceptibility to priming and cognitive distortions about gambling. In addition, correlations, multiple linear regressions and a simple mediation model of these variables were analyzed.

RESULTS

The results indicated that gambling addiction was correlated with a variety of clinical, social and cognitive factors. These factors contributed to a model that predicted 16.8% of the variance in gambling addiction and another model using cognitive distortions as a predictor and the maximum bet as a mediator that predicted 34.5% of the variance.

CONCLUSIONS

The study represents an advance by developing a theoretical model from an integrative perspective and providing a new explanatory model. The findings of this research are of great importance in the development of prevention and intervention programs for gambling addiction.

Comparative Analysis of Three Predictive Models of Performance Indicators with Results-Based Management: Cancer Data Statistics in a National Institute of Health

Predictive models play a crucial role in RBMs to analyze performance indicator results to manage unexpected events and make timely decisions to resolve them. Their use in Mexico is deficient, and monitoring and evaluation are among the weakest pillars of the model. In response to these needs, the aim of this study was to perform a comparative analysis of three predictive models to analyze 10 medical performance indicators and cancer data related to children with cancer. To accomplish these purposes, a comparative and retrospective study with nonprobabilistic convenience sampling was conducted. The predictive models were exponential smoothing, autoregressive integrated moving average, and linear regression. The lowest mean absolute error was used to identify the best model. Linear regression performed best regarding nine of the ten indicators, with seven showing p < 0.05. Three of their assumptions were checked using the Shapiro-Wilk, Cook's distance, and Breusch-Pagan tests. Predictive models with RBM are a valid and relevant instrument for monitoring and evaluating performance indicator results to support forecasting and decision-making based on evidence and must be promoted for use with cancer data statistics. The place numbers obtained by cancer disease inside the main causes of death, morbidity and hospital outpatients in a National Institute of Health were presented as evidence of the importance of implementing performance indicators associated with children with cancer.

The Columbia-suicide severity rating scale: validity and psychometric properties of an online Spanish-language version in a Mexican population sample

The aim of this study was to evaluate the validity and psychometric properties in a Mexican sample of a Spanish-language online version of the Columbia-Suicide Severity Rating Scale (C-SSRS). Data were collected between May and October 2021 from 3,645 participants aged 18 years and over, who agreed to complete the questionnaire. Reliability analysis, confirmatory factor analysis (CFA), and psychometric properties were calculated using a two-parameter model. The results showed a reasonable level of reliability with a Cronbach's alpha of 0.814, and evidence of unidimensionality, and construct validity for suicide risk at three risk levels: low, medium, and high. Analysis of the items suggests that they are consistent with the proposed theoretical model. Our results also demonstrate that the parameters are stable and able to efficiently discriminate individuals at high risk of suicide. We propose the use of this version of the C-SSRS in the Spanish-speaking population, since it is a multifactorial assessment of suicide risk and the inclusion of other clinical and risk factor assessments for a more comprehensive evaluation.

Eventos de vida estresantes y su efecto en la conducta suicida en mujeres durante la pandemia por Covid-19 en México

OBJETIVO

Analizar la estructura factorial, la validez convergente y divergente de la Escala Columbia de Severidad Suicida (CSSRS) y el Cuestionario de Eventos de Vida Estresantes (EVE) y medir la asociación entre EVE y conducta suicida (CS) en mujeres mexicanas durante la pandemia por Covid-19. Material y métodos. Se usaron datos de 2 398 mujeres que participaron en un estudio multicéntrico, realizado en México entre mayo y octubre de 2021. La información se recolectó mediante un cuestionario en línea que incluyó la CSSRS y el EVE. Se hizo un análisis factorial confirmatorio para valorar el ajuste de los modelos.

RESULTADOS

El modelo final mostró asociación entre los EVE y la CS, y tuvo a la violencia como variable central. Dicho modelo presentó un ajuste adecuado (CFI = 0.950, IFI = 0.950, MFI = 0.975, RMSEA = 0.031, CI RMSEA = 0.026-0.036).

CONCLUSIONES

La pandemia por Covid-19 evidenció la necesidad de crear e implementar estrategias que promuevan el cuidado de la salud mental, reduzcan la exposición a la violencia y faciliten los procesos de duelo para prevenir la CS en mujeres mexicanas.

Design, Development, and Validation of the Self-Perceived Health Scale (SPHS)

Health is a multidimensional concept with notable psychological factors, such as self-perceived health (SPH). SPH is defined as the subjective assessment of individual health status, and it integrates information related to both physical and psychological aspects, such as lifestyle. This study describes the development of the Self-Perceived Health Scale (SPHS), and its validation in a Mexican sample (n = 600). Exploratory factor analysis (n = 303) and confirmatory factor analysis (n = 293) were carried out, and they supported the three-dimensionality of the SPH construct: physical health, psychological health, and healthy lifestyle. A final 12-item scale was obtained, and the scale showed adequate validity and reliability, as well as measurement invariance between sexes, indicating its robustness.

Positive Mental Health Scale (PMHS) in Parents of Children with Cancer: A Psychometric Evaluation Using Item Response Theory

Mental health is currently a public health issue worldwide. However, evidence is lacking regarding the validity of the instruments used to measure and assess positive mental health in specific populations. The objective of this study was to evaluate the psychometric properties of the PMHS using IRT. A cross-sectional retrospective study with non-probabilistic convenience sampling was conducted with 623 parents of children undergoing cancer treatment at the National Institute of Health in Mexico City. The participants responded to a battery of tests, including a sociodemographic questionnaire, the PMHS, Measurement Scale of Resilience, Beck Depression Inventory, Inventory of Quality of Life, Beck Anxiety Inventory, an interview regarding caregiver burden, and the World Health Organization Well-Being Index. PMHS responses were analyzed using Samejima's graded response model. The PMHS findings indicated that the IRT-based graded response model validated the single latent trait model. The scale scores were independent of depression, anxiety, well-being, caregiver burden, quality of life, and resilience. The PMHS scores were associated with low subjective well-being. The PMHS findings reveal that from an IRT-based perspective, this scale is unidimensional and is a valid, reliable, and culturally relevant instrument for assessing positive mental health in parents of children with chronic diseases.

Psychosocial Factors Associated with Self-Management in Patients with Diabetes

Despite the significant advances in research on diabetes, relatively few researchers have examined the theoretical and empirical usefulness of explanatory models that contribute to self-management of the disease. In response to the theoretical and empirical approaches related to this topic, the objective of this research was to assess a hypothetical model to explain self-management behavior in patients with type II diabetes through structural equation modeling in a population of users of the services of the State Health Department of Tamaulipas, Mexico. The study used a cross-sectional and explanatory design. The sample was intentional. A total of 183 patients with a diabetes diagnosis completed a sociodemographic data questionnaire, the Partners in Health Scale, the Duke-UNC-11, the Family Apgar, the Self-Efficacy Scale, the Personal Health Questionnaire and the Physical Activity Scale. The results indicated that the hypothetical model was improved by excluding the exercise variable. The appropriate model was used to determine the effects of depression, social support, self-efficacy, family functioning, years of formal education and years with a diagnosis on self-management. The goodness-of-fit indices (GFIs) were good, i.e., χ²/gl = 0.89 (p = 0.529), root mean square error of approximation (RMSEA) = 0.000, and comparative fit index (CFI) = 1.000, with an acceptable degree of parsimony (PNFI = 0.409 and PGFI = 317). The model explained 33.6% of the variance. Therefore, this model represents an important advance in knowledge concerning self-management and provides empirical and theoretical evidence, particularly for the Mexican or Latino population.

Cost-effectiveness analysis of a hand hygiene monitoring system in a tertiary pediatric hospital in Mexico

Background

An automated hand-hygiene monitoring system (AHHMS) was implemented in October 2019 at the Hospital Infantil de México Federico Gómez (HIMFG), a tertiary pediatric referral hospital, in four of the hospital wards with the highest rates of Healthcare Associated Infections (HAIs). The clinical and economic impact of this system had not yet been assessed prior to this study. This study aimed to evaluate if the AHHMS is a cost-effective alternative in reducing HAIs in the HIMFG.

Methodology

A full cost-effectiveness economic assessment was carried out for the hospital. The alternatives assessed were AHHMS implementation vis-a-vis AHHMS non-implementation (historical tendency). The outcomes of interest were infection rate per 1,000 patient-days and cost savings as a result of prevented infections. Infection rate data per 1,000 patient-days (PD) were obtained from the hospital's Department of Epidemiology with respect to the AHHMS. As regards historical tendency, an infection-rate model was designed for the most recent 6-year period. Infection costs were obtained from a review of available literature on the subject, and the cost of the implemented AHHMS was provided by the hospital. The assessment period was 6 months. The incremental cost-effectiveness ratio was estimated. Costs are reported in US Dollars (2021). Univariate sensitivity and threshold analysis for different parameters was conducted.

Results

The total estimated cost of the AHHMS alternative represented potential savings of $308,927–$546,795 US Dollars compared to non-implementation of the system (US$464,102 v. US$773,029–$1,010,898) for the period. AHHMS effectiveness was reflected in a diminished number of infections, 46–79 (−43.4–56.7%) compared to non-implementation (60 v. 106-139 infections).

Conclusion

The AHHMS was found to be a cost-saving alternative for the HIMFG given its cost-effectiveness and lower cost vis-a-vis the alternate option. Accordingly, the recommendation was made of extending its use to other areas in the hospital.

Psychological distress, intimate partner violence and substance use in a representative sample from Mexico: A structural equation model

Introduction

Intimate Partner Violence (IPV) is a public health concern associated with multiple adverse health outcomes, including psychological distress (PD).

Objective

To assess the association of IPV and psychological distress, and the mediation of tobacco and alcohol consumption in a national representative sample from Mexico.

Material and methods

Data from the Encuesta Nacional de Consumo de Drogas, Tabaco y Alcohol (ENCODAT) were analyzed. The sample included 34,864 people between the ages of 12 and 65 with a partner. Using Structural Equation Modeling (SEM), the association between IPV, use alcohol, tobacco and psychological distress was measured.

Results

The population was composed of women (51.9%) and men (48.1%); 15.1% (women = 18.2% and men = 11.9%) reported IPV in the last year. The prevalence of psychological distress in the last year was 3.3%, being 3.8% in women, and 2.7% in men. Results from the SEM in women indicated a direct positive effect of the IPV construct on psychological distress (β = 0.298, p < 0.01); these findings confirmed that IPV tended to systematically increase psychological distress. Likewise, the presence of IPV increased the consumption of tobacco (β = 0.077, p < 0.01) and alcohol (β = 0.072, p < 0.01). The SEM results in men showed that alcohol and tobacco consumption tended to increase in the presence of IPV (β = 0.121, p < 0.01, and β = 0.086, p < 0.01, respectively), and in turn, alcohol consumption and tobacco tended to increase psychological distress (β = 0.024, p < 0.01, and β = 0.025, p < 0.01, respectively).

Conclusion

This study indicated that in women, IPV had a direct effect on psychological distress and on alcohol and tobacco consumption. Meanwhile in men, alcohol and tobacco consumption had a mediating effect between IPV and psychological distress. The empirical findings of this study will contribute toward the design of public health policies for the prevention and attention of IPV, alcohol and tobacco consumption, and consequently address the mental health consequences derived from these problems.

Correction: Martínez-Valverde et al. Health Needs Assessment: Chronic Kidney Disease Secondary to Type 2 Diabetes Mellitus in a Population without Social Security, Mexico 2016-2032. Int. J. Environ. Res. Public Health 2022, 19, 9010

In the original publication [...].

Medical outcomes study social support survey (MOS-SSS) in patients with chronic disease: A psychometric assessment

Purpose

Currently, information on the psychometric properties of the Medical outcomes study-social support survey (MOS-SSS) for patients with chronic disease in primary health care, suggests problems in the dimensionality, specifically predominant unidimensionality in a multidimensional measure. The aim of this study was to determine the internal structure (dimensionality, measurement invariance and reliability) and association with other variables.

Methods

A total of 470 patients with chronic disease from a Family Medicine Unit at the Instituto Mexicano del Seguro Social, IMSS, with a mean age of 51.51 years were included. Participants responded to the Questionnaire of Sociodemographic Variables (Q-SV), SF-36 Health-Related Quality of Life Scale-version 1.1, and MOS-SSS.

Results

Non-parametric (Mokken scaling analysis) and parametric (confirmatory factor analysis) analyses indicated unidimensionality, and three-factor model was not representative. A new 8-item version (MOS-S) was developed, where measurement invariance, equivalence with the long version, reliability, and relationship with the SF-36 were satisfactory.

Conclusion

The MOS-SSS scale is unidimensional, and the shortened version yields valid and reliable scores for measuring social support in patients with chronic disease at the primary health care.

Measurement invariance of the GAD-5 Generalized Anxiety Disorder Scale in a Mexican general population sample

The primary objective of this study was to evaluate the measurement of invariance by sex, age, and educational level of an online version of the Generalized Anxiety Disorder Scale in a five-item version (GAD-5). Configural, metric, scalar, and strict invariance were evaluated using data from 79,473 respondents who answered a mental health questionnaire during the COVID-19 pandemic in Mexico. The sex variable was classified as male or female; age was categorized as minors, youth, young adults, adults, and older adults; and educational level was divided into basic, upper secondary, higher, and graduate education. To test for configural invariance, confirmatory factor models were constructed. For metric invariance, equality restrictions were established for the factor loadings between the construct and its items; for scalar invariance, equality restrictions were established between the intercepts; strict variance implied the additional restriction of the residuals. Statistical analysis was performed in R software with the lavaan package. The results show that with respect to sex, age, and educational level, configural and metric measurement invariance was confirmed (ΔCFI < 0.002; ΔRMSEA < 0.015). However, with respect to scalar and strict invariance, the results showed significant differences regarding the fit model (ΔCFI > 0.002; ΔRMSEA > 0.015). We conclude that the GAD-5 presents configural and metric invariance for sex, age, and educational level, and scalar invariance for sex and age groups. However, the scale does not demonstrate strict invariance. We discuss the implications and suggest that this result could be related to the evaluation of sociodemographic variables.

Decision Making in Addictive Behaviors Based on Prospect Theory: A Systematic Review

Traditionally, research on addictive behaviors has been based on the study of their risk factors, with impulsivity being the main risk factor. However, this study aims to approach this topic from the analysis of decision making. According to the prospect theory, low levels of loss and risk aversion will increase the probability of showing addictive behaviors. A systematic review of the possible relationships between these behaviors and prospect theory was carried out. To this end, the works that have studied loss and risk aversion in populations with addictive behaviors to date (N = 15) were compiled. Apart from other eligibility criteria, the selection process was only performed with studies that included the prospect theory or cumulative prospect theory, in English or Spanish, since 1979. WoS, Scopus, Dialnet and PsycInfo were the information sources selected. For this purpose, PRISMA guidelines have been followed. It was found that users of addictive substances show less loss aversion than nonusers. These results cannot be transferred to pathological gamblers. The significance of this work for future research and the implementation of prevention and intervention programs is highlighted. The results show an approach to addictions from a novel perspective.

Health Needs Assessment: Chronic Kidney Disease Secondary to Type 2 Diabetes Mellitus in a Population without Social Security, Mexico 2016-2032

Health needs assessment is a relevant tracer of planning process of healthcare programs. The objective is to assess the health needs of chronic kidney disease (CKD) secondary to type 2 diabetes mellitus (T2 DM) in a population without social security in Mexico. The study design was a statistical simulation model based on data at the national level of Mexico. A stochastic Markov model was used to simulate the progression from diabetes to CKD. The time horizon was 16 years. The results indicate that in 2022, kidney damage progression and affectation in the diabetic patient cohort will be 34.15% based on the time since T2 DM diagnosis. At the end of the 16-year period, assuming that the model of care remains unchanged, early renal involvement will affect slightly more than twice as many patients (118%) and cases with macroalbuminuria will triple (228%). The need for renal replacement therapy will more than double (169%). Meanwhile, deaths associated with cardiovascular risk will more than triple (284%). We concluded that the clinical manifestations of patients with CKD secondary to T2 DM without social security constitute a double challenge. The first refers to the fact that the greatest health need is early care of CKD, and the second is the urgent need to address cardiovascular risk in order to reduce deaths in the population at risk.

Sense of Coherence and Work Stress or Well-Being in Care Professionals: A Systematic Review

Job-related stress affects the physical and psychological health of professionals dedicated to care. This work is a systematic review that aims to determine the relationships between a sense of coherence (SOC) and work stress and well-being perceived by care professionals. The review was carried out following the PRISMA guidelines, and the search was carried out using the Web of Science (WoS), PubMed, and Scopus databases, obtaining a final selection of 41 articles. The results indicate that stress, depression, burnout, and posttraumatic stress disorder (PTSD) negatively correlate with SOC; in contrast, job satisfaction, well-being, and quality of life positively correlate with SOC. It is concluded that SOC could act as a mediating variable and as a predictor variable of these health problems.

Estudio de la calidad de vida en cuidadores familiares de personas con discapacidad intelectual

Objetivo. Explorar las experiencias y percepciones de la calidad de vida (CV) en cuidadores familiares (CF) de personas con discapacidad intelectual (PDI) en Morelos y Sinaloa, México. Material y métodos. Estudio cualitativo. Se realizaron 18 entrevistas semiestructuradas a CF de PDI que asistían a escuelas básicas públicas en Huitzilac, Morelos y Culiacán, Sinaloa, México. Se realizó análisis de contenido con apoyo del programa ATLAS.ti.8.0. Resultados. Los CF experimentaron un deterioro en distintas dimensiones: bienestar emocional, físico y material, desarrollo personal, autodeterminación y relaciones interpersonales, deterioro que afecta negativamente su CV. Los lazos de empatía, acompañamiento y motivación con otros CF son beneficiosos y los libera de actividades por lapsos breves, disminuyendo así la carga del cuidado de una PDI. Conclusiones. Cuidar a una PDI puede afectar negativamente la CV de las y los CF. Se sugiere el desarrollo de intervenciones para atención, apoyo y orientación integral; asimismo, crear y fortalecer grupos de ayuda mutua con otros cuidadores.

Effects of Anonymity versus Examinee Name on a Measure of Depressive Symptoms in Adolescents

There is evidence in the literature that anonymity when investigating individual variables could increase the objectivity of the measurement of some psychosocial constructs. However, there is a significant gap in the literature on the theoretical and methodological usefulness of simultaneously assessing the same measurement instrument across two groups, with one group remaining anonymous and a second group revealing identities using names. Therefore, the aim of this study was to compare the psychometric characteristics of a measure of depressive symptoms in two groups of adolescents as a consequence of identification or anonymity at the time of answering the measuring instrument. The participants were 189 adolescents from Metropolitan Lima; classrooms were randomly assigned to the identified group (n = 89; application requesting to write one’s own name) or to the anonymous group (n = 100; application under usual conditions), who responded to the Childhood Depression Inventory, short version (CDI-S). Univariate characteristics (mean, dispersion, distribution), dimensionality, reliability, and measurement invariance were analyzed. Specific results in each of the statistical and psychometric aspects evaluated indicated strong psychometric similarity. The practical and ethical implications of the present results for professional and research activity are discussed.

Brief Sensations Seeking Scale (BSSS): Validity Evidence in Mexican Adolescents

Sensation seeking is a construct associated with risky behaviors over a wide age range, but validation studies in Mexico are lacking. The aim of this study was to investigate the validity of two versions of the Brief Sensation Seeking Scale (the BSSS-8 and BSSS-4) in young Mexican individuals. The sample consisted of 2884 students (age: M = 16.6, SD = 1.5) from five preparatory schools in Morelos, Mexico. The internal structure of the BSSS was evaluated according to the structural equation modeling (SEM) parameterization, including measurement invariance (compared to the factor loadings obtained in the meta-analysis); conditional reliability; and equivalence between versions. The unidimensionality and measurement invariance (configurational, factor loadings, thresholds, intercepts, and residuals) across sex and age groups were satisfactory, and the factor loadings were highly congruent with those obtained in the meta-analysis. Reliability was suitably high (greater than 0.80), especially near the mean scores, but was lower for extreme scores. Thus, the instrument was concluded to be optimal for defining the construct of sensation seeking, consistent with the findings of previous studies.

Parametric and Nonparametric Analysis of the Internal Structure of the Psychosocial Work Processes Questionnaire (PROPSIT) as Applied to Workers

The study of the dimensionality or internal structure of a measure has a definitional purpose with notable theoretical and practical implications; this aspect can be analyzed via both parametric and nonparametric approaches. The latter are probably used less often to validate constructs in the context of psychosocial work factors. The aim of the present manuscript was to employ both nonparametric (DETECT and AISP-Mokken) and parametric (semiconfirmatory factor analysis) procedures to analyze the internal structure of the Psychosocial Work Processes Questionnaire (PROPSIT) in the context of two samples of Peruvian workers located in the city of Lima, Perú, with one sample drawn from various work centers (n = 201) and the other comprising elementary education teachers (n = 158). The nonparametric results indicated that the content of the PROPSIT is sufficiently multidimensional to be able to describe a variety of psychosocial factors, while the parametric results require modification of the measurement model to obtain greater factorial congruence. In general, the analyses show a similar structure to those discussed by previous preliminary studies that have reported similar item-level performances. Some findings and considerations for future research are discussed.

Morpho-agronomic evaluation of native maize races associated with Mexican tropical climate agroforestry systems

Maize (Zea mays L.) is native to Mexico, in which wide genetic diversity can be found; however, maize is at risk of genetic erosion, and agroforestry systems (ASs) can be a strategy for conservation and sustainable use of this crop. The objective of this study was to evaluate the variation in the morpho-agronomic characteristics of three native maize races, Tuxpeño, Olotillo × Tuxpeño and Ratón × Tepecintle, cultivated in different AS in a tropical climate of Veracruz, Mexico, as well as its association with microclimatic conditions. In 2019, experiments were established in the localities La Gloria and La Luisa, Veracruz, where the three maize races are cultivated, in a randomized complete block design with three replications in a 3 × 4 factorial scheme (three native maize races and three AS arrrays, plus monoculture). Ten morpho-agronomic variables were recorded in each experiment and were analyzed by analysis of variance (ANOVA; Tukey's post-hoc test, all p ≤ 0.05) and principal component analysis (PCA). Six morpho-agronomic characteristics showed significant differences for the race × system interaction. Consistently standing out both in the Myroxylon with 2.8 m × 2.0 arrays and in the monoculture was the Olotillo × Tuxpeño race, as there were no variations (p ≥ 0.05) in 50% of its morpho-agronomic characteristics. The first three PCs explained 87.7% of the cumulative variance, determined by five variables of the ears, three of the grain and plant height, which were associated with temperature; therefore, the microclimatic conditions of the studied ASs are associated with the morpho-agronomic characteristics of the native maize races. The results show that ASs could be a strategy for the conservation and use of native corn germplasm and could allow the diversification of sustainable production for rural farmers.

A University and Community-Based Partnership: After-School Mentoring Activities to Support Positive Mental Health for Children Who Are Refugees

The objective of this study was to examine mentors’ perceptions of a pilot service-learning program designed to provide activities to promote the self-esteem and positive development of elementary school-age children who were refugees. Activities were designed to promote self-esteem, self-confidence, social skills development, and problem-solving. College students completed reflection journals to record their perceptions of mentoring and what the children were learning and experiencing. The results indicated that mentors believed the children were learning ideas to improve their self-esteem and social development. Mentors’ impressions were corroborated by reports about the program from staff who worked with the children daily. Involving parents in programming, may have extended the reach of program efforts. Some children may have benefited from evaluations to determine if counseling would benefit them, given the trauma history they and their family members were potentially facing. This was a pilot program implementation study, and a limitation is that data from youth and parents about mental health outcomes were lacking. In the future, assessing perceptions of children, involving their caregivers in programming, and then assessing their caregivers’ perceptions of the impact of the program on children’s self-esteem and social and emotional functioning will provide critical information about program success and information for program development.

Ultrashort Version of the Utrecht Work Engagement Scale (UWES-3): A Psychometric Assessment

The objective was to determine the validity of the UWES-3, an ultrashort measure of work engagement lacking evidence in Hispanic populations. In total, 200 workers with heterogeneous positions and careers from Metropolitan Lima were enrolled via nonprobabilistic sampling. The UWES-3 and measures of external variables (work accidents, stress overload, and others) were used. Data were collected through a web platform. Items were analysed, nonparametric response theory methods (Mokken scale analysis and Ramsay curves) were applied to the items, and ordinal and linear regression were used to determine the relationships with external variables. The items had statistically similar distributional properties and monotonic associations with external variables but with fewer functional response options. The UWES-3 complied with the monotonic homogeneity model and invariant ordering of items; the scaling of the items, score (greater than 0.80), and reliability (0.94) were high. With the effects of age and sex controlled, the UWES-3 significantly predicted minor accidents at work and job satisfaction and revealed effects of stress overload and perceived efficacy. The theoretical implications of the UWES-3 as a brief unidimensional measure integrating the three original dimensions of the instrument and the practical implications of its use for research and professional practice are discussed.

Social Networks Addiction (SNA-6) - Short: Validity of Measurement in Mexican Youths

The excessive use of social networks needs to be addressed, and this phenomenon needs to be measured for the purpose of evaluation, prevention, and intervention among adolescents and young people. The objective of the study was to adapt and psychometrically validate the Brief Scale of Addiction to Social Networks (SNA-6) among Mexican adolescents and young adults. The participating sample consisted of 2,789 students from 6 public educational campuses in Cuernavaca (Morelos, Mexico). Data collection was carried out through a web platform to strictly maintain anonymity, voluntary participation, and confidentiality. Data analysis first focused on the detection of possible response biases (random intercept model and careless/insufficient effort), the quality of the response structure partial credit model (PCM), dimensionality (CFA and invariance), and the relationship with external variables. It was found that when the range of efficient response options was limited to less than five, reliability was high (0.91), and unidimensionality was maintained. Response biases slightly affected the dimensional structure of the instrument. Measurement invariance reached scalar invariance in the sex, age, and campus groups. The association with sensation seeking and depression, controlling for sex and age covariates, was statistically significant, small, and theoretically consistent. Implications of the results are discussed.

Resilience measurement scale in family caregivers of children with cancer: Multidimensional item response theory modeling

BACKGROUND

Currently, information about the psychometric properties of the Resilience Measurement Scale (RESI-M) in family caregivers of children with cancer according to item response theory (IRT) is not available; this information could complement and confirm the findings available from classical test theory (CTT). The objective of this study was to test the five-factor structure of the RESI-M using a full information confirmatory multidimensional IRT graded response model and to estimate the multidimensional item-level parameters of discrimination (MDISC) and difficulty (MDIFF) from the RESI-M scale to investigate its construct validity and level of measurement error.

METHODS

An observational study was carried out, which included a sample of 633 primary caregivers of children with cancer, who were recruited through nonprobabilistic sampling. The caregivers responded to a battery of tests that included a sociodemographic variables questionnaire, the RESI-M, and measures of depression, quality of life, anxiety, and caregiver burden to explore convergent and divergent validity.

RESULTS

The main findings confirmed a five-factor structure of the RESI-M scale, with RMSEA = 0.078 (95% CI: 0.075, 0.080), TLI = 0.90, and CFI = 0.91. The estimation of the MDISC and MDIFF parameters indicated different values for each item, showing that all the items contribute differentially to the measurement of the dimensions of resilience.

CONCLUSION

That regardless of the measurement approach (IRT or CTT), the five-factor model of the RESI-M is valid at the theoretical, empirical, and methodological levels.

Disability-Adjusted Life Years for the COVID-19 Pandemic in the Mexican Population

Mexico is one of the countries most affected by the COVID-19 disease. Although there is vast information on the disease, there still are unknown data on the societal and economic cost of the pandemic. To estimate this impact, the disability-adjusted life years (DALYs) can be a useful tool. Objective: To assess the DALYs due to COVID-19 in Mexico. Methods: We used the data released by the Mexican Ministry of Health to estimate the DALYs by the sum of the years of life lived with disability (YLDs) and the years of life lost (YLLs). Results: A total of 1,152,885 confirmed cases and 324,570 suspected cases of COVID-19 have been registered. Half of the cases were men, with a median age of 43.4 ± 16.9 years. About 8.3% died. A total of 39,202 YLDs were attributable to COVID-19. The total YLLs caused by COVID-19 were 2,126,222. A total of 2,165,424.5 DALYs for COVID-19 were estimated. The total DALYs were the highest in people between 50 and 59 years. The DALYs for each COVID-19 case were the highest in individuals between 60 and 79 years. Conclusion: The DALYs generated by the COVID-19 represent a more significant disease burden than that reported for other causes, such as the 2009 H1N1 influenza pandemic. Although it impacts all age groups in terms of disability, the most affected group are people over 50 years of age, whose risk of death is higher.

Validez y confiablidad de la Escala de Apoyo Social Percibido (MSPSS)

Introducción: Existe evidencia de que el apoyo social es una variable fundamental en la investigación y en la intervención con familias en contextos de salud y enfermedad crónica. Objetivo: Obtener las propiedades psicométricas de la Escala de Apoyo Social Percibido (MSPSS) en cuidadores primarios informales de pacientes con cáncer. Método: Estudio instrumental, en el que se entrevistó a 257 cuidadores primarios informales (CPI) que acudían a consulta externa en un Instituto Nacional de Salud en la Ciudad de México para el tratamiento contra el cáncer. Los participantes fueron seleccionados de manera no probabilística, de los cuales 227 eran mujeres (83,7%); con un rango de edad de 18 a 65 años (M =31, DT = 9,06); el 45,6% estaban casados, 61,11% tenían hijos y dedicaban más de 30 horas a la semana al cuidado del paciente. Los cuidadores respondieron un cuestionario de datos sociodemográficos y clínicos, la MSPSS (versión traducida al español) y la Escala de Malestar Psicológico de Kessler (K-10). Se realizó un análisis factorial confirmatorio (AFC) y un análisis de confiabilidad (Coeficiente Alfa de Cronbach). Resultados: El AFC obtuvo índices de ajuste para la MSPSS (CMIN 55,23; GFI 0,997; AGFI 0,995; NFI 0,996; RMR 0,053), y un coeficiente confiabilidad para la escala completa α=0,908. Además, se probó la validez de criterio divergente mediante la correlación de los puntajes de la MSPSS y los puntajes de la K-10. Conclusiones: Este estudio aporta evidencias de validez y confiabilidad satisfactorias para la MSPSS y, por tanto, es un instrumento sensible para la medición de apoyo social en poblaciones de cuidadores familiares de pacientes con enfermedades crónicas.

Needs assessment: knowledge of self-management of asthma for children with co-morbid physical and intellectual disabilities: brief report

OBJECTIVES: 

The main goal of this study was to conduct a needs assessment to ascertain professionals' and parents' knowledge of and perceptions about education for self-management of asthma for children with physical and intellectual disabilities (IDs). Another goal was to understand needs for education of children with IDs about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; coronavirus) and other infectious diseases.

METHODS: 

Surveys, presented in the RedCap system, were administered online. Respondents (n = 498) were recruited through sites and listservs for children with disabilities and individuals with asthma. Respondents answered eight questions about knowledge and education for self-management of asthma for children with physical disabilities and IDs. Respondents answered four questions pertaining to management of coronavirus for children with IDs.

RESULTS: 

Respondents' indicated that it would be easier to educate youth with mild or moderate versus severe levels of disabilities. Children with IDs may not receive the education they need to manage their asthma. When comparing those in different occupations, teachers reported lower knowledge for educating children with IDs about asthma management and coronavirus.

CONCLUSIONS: 

Doctors and nurses can develop programs for children with physical disabilities and IDs. Programming for youth with severe impairments is needed and perhaps developmentally appropriate programming for youth with IDs will improve education of youth and, concomitantly improve their self-management of asthma and potentially quality of life. Educating teachers is critical specifically about asthma triggers, how to involve youth in self-care, and how to educate children with IDs about coronavirus.Abbreviations:U.S.: United States;IDs: intellectual disabilities.

Predictors of Quality of Life among Parents of Children with Chronic Diseases: A Cross-Sectional Study

Quality of life (QOL) is a key aspect of the health care process for children with chronic diseases and their families. Although clinical evidence regarding the impact of chronic disease on children exists, few studies have evaluated the effects of the interaction between sociodemographic and psychosocial factors on the family caregiver's QOL, indicating a significant gap in the research literature. The present study aimed to identify the predictors of the QOL of parents of children with chronic diseases. Three parental sociodemographic predictors (age, schooling, and family income) and four psychosocial predictors (family functioning, social support, depression, and resilience) were examined. In this cross-sectional study, 416 parents of children with chronic diseases who were hospitalized at a National Institute of Health in Mexico City were interviewed. The participants completed a sociodemographic variables questionnaire (Q-SV) designed for research on family caregivers of children with chronic disease. The predicted variable was assessed through the World Health Organization Quality of Life Questionnaire. The four psychosocial predictors were assessed through the Family Functioning Scale, Social Support Networks Scale, Beck Depression Inventory, and Measurement Scale of Resilience. The regression model explained 42% of the variance in parents' QOL. The predictors with positive weights included age, schooling, monthly family income, family functioning, social support networks, and parental resilience. The predictors with negative weights included depression. These findings suggest that strong social relationships, a positive family environment, family cohesion, personal resilience, low levels of depression, and a family income twice the minimum wage are variables associated with better parental QOL.

A survival analysis of COVID-19 in the Mexican population

Background

At present, the Americas report the largest number of cases of COVID-19 worldwide. In this region, Mexico is the third country with most deaths (20,781 total deaths). A sum that may be explained by the high proportion of people over 50 and the high rate of chronic diseases. The aim of this analysis is to investigate the risk factors associated with COVID-19 deaths in Mexican population using survival analysis.

Methods

Our analysis includes all confirmed COVID-19 cases contained in the dataset published by the Epidemiological Surveillance System for Viral Respiratory Diseases of the Mexican Ministry of Health. We applied survival analysis to investigate the impact of COVID-19 on the Mexican population. From this analysis, we plotted Kaplan-Meier curves, and constructed a Cox proportional hazard model.

Results

The analysis included the register of 16,752 confirmed cases of COVID-19 with mean age 46.55 ± 15.55 years; 58.02% (n = 9719) men, and 9.37% (n = 1569) deaths. Male sex, older age, chronic kidney disease, pneumonia, hospitalization, intensive care unit admission, intubation, and health care in public health services, were independent factors increasing the risk of death due to COVID-19 (p < 0.001).

Conclusions

The risk of dying at any time during follow-up was clearly higher for men, individuals in older age groups, people with chronic kidney disease, and people hospitalized in public health services.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-020-09721-2.

The psychosocial profile of family caregivers of children with chronic diseases: a cross-sectional study

Background

A family caregiver is defined as a person who has a significant emotional bond with the patient; this caregiver is a family member who is a part of the patient’s family life cycle; offers emotional-expressive, instrumental, and tangible support; and provides assistance and comprehensive care during the chronic illness, acute illness, or disability of a child, adult, or elderly person. The objectives of this study were to identify the psychosocial profiles of family caregivers of children with chronic diseases and to establish the relationship between these profiles and sociodemographic variables.

Methods

A cross-sectional study was conducted involving 401 family caregivers of children with chronic diseases at the National Institute of Health in Mexico City. The participants responded to the Sociodemographic Variables Questionnaire (Q-SV) for research on family caregivers of children with chronic disease and a battery of 7 instruments that examined anxiety, caregiver burden, family support, depression, resilience, parental stress, and the World Health Organization Well-Being Index.

Results

A hierarchical cluster analysis and its confirmation through a nonhierarchical cluster analysis confirmed two profiles of caregivers of pediatric patients with chronic diseases. Profile 1, called Vulnerability of family caregivers, is characterized by high levels of anxiety, depression, parental stress and caregiver burden, accompanied by low levels of family support, resilience, and well-being. Profile 2, called Adversity of family caregivers, shows an inverse pattern, with high levels of family support, resilience, and well-being and low levels of anxiety, depression, parental stress and caregiver burden. The sociodemographic characteristics are similar for both profiles, with the exception of the caregiver’s family type. Profile 1 shows more single-parent caregivers, while profile 2 includes more caregivers with a nuclear family. However, the type of family did not reach significance for predicting the caregiver’s profile in a bivariate logistic regression model.

Conclusions

The psychosocial profile of family caregivers of children with chronic diseases can be structured according to their psychosocial characteristics. Although no causal factors were detected that define criteria for belonging to one or another profile, the characteristics identified for each indicate the need for specific and differentiated intervention strategies for families facing adversity, risk and vulnerability during a child’s disease.

Brief version of the coping health inventory for parents (CHIP) among family caregivers of children with chronic diseases

Background

The Coping Health Inventory for Parents (CHIP) has demonstrated good psychometric properties in several language forms and has been used to assess the coping behaviors of families facing disease. However, the CHIP has not been validated in Mexico among families of children with chronic conditions, where it could be useful for research and intervention. The objectives of this instrumental study were to obtain a version of the CHIP for the Spanish language in Mexico, establish the factor structure of the Mexican version of the CHIP, probe its internal consistency reliability, and assess its concurrent construct validity.

Methods

A nonprobability sample of 405 family caregivers of children with chronic diseases responded to a battery of measurement instruments that included the CHIP, the Beck Anxiety Inventory, and the Beck Depression Inventory. The sample was randomly divided into two parts. In one subsample (190 participants), an exploratory factor analysis was performed using a principal component analysis and oblique rotation. In the second subsample (215 participants), a confirmatory factor analysis was performed using maximum likelihood estimation.

Results

The scale was reduced to 16 items (CHIP-16) with factorial loads greater than .50. The empirical criteria used to determine the number of factors converged on the following five factors: belief and trust (McDonald ω = .85), spouse/partner relationship (ω = .79), home care (ω = .77), family involvement (ω = .75), and security/stability (ω = .79). The overall internal consistency was good (ω = .88). The five-factor model showed acceptable fit indices and high parsimony. The mean CHIP-16 scores and the Spouse/partner relationship scores among the caregivers with anxiety were greater than those among the caregivers without anxiety. The mean home-care scores among the women were greater than those among men.

Conclusions

The 16-item version of the CHIP showed good internal consistency and construct validity; thus, the CHIP-16 is a useful instrument for measuring and assessing coping in family caregivers of children with chronic diseases.

Communicating bad news in the context of COVID-19

Communicating bad news is one of the most frequent activities in hospitals, for which some recommendations have been adapted to the needs within the coronavirus-2 disease (COVID-19) context. This document presents nine steps to deliver bad news (face to face or remotely) adapted to the COVID-19 context from two international protocols (SPIKES and GRIEV_ING). The importance of promoting physical and emotional self-care skills in health personnel is also described, as well as psychological first aid strategies to address the emotional response of the family member who receives the news. Finally, the limitations and advantages of the proposal should be considered.

A Sociodemographic variables questionnaire (Q-SV) for research on family caregivers of children with chronic disease

Background

Chronic diseases in childhood can affect the physical and mental health of patients and their families. The literature on pediatric chronic diseases has found important associations between the sociodemographic variables of children and their caregivers and negative health consequences in families.

Methods

In this study, we aimed to design and validate a questionnaire on sociodemographic variables that would be useful for research on pediatric chronic diseases; and investigate the relationship between sociodemographic variables and psychosocial variables among family caregivers. First, we created a questionnaire that consists of 20 demographic, medical, and family-related items based on a literature review and expert evaluations. This questionnaire was then validated by 335 expert reviewers in the field of Social Work, who work daily with the families of patients with chronic diseases in 10 National Institutes of Health of Mexico. The validation was based on three empirical criteria created specifically for this study, and the reviewers evaluated the usefulness, relevance, and permanence of the items. In a second cross-sectional, correlational and comparative study, a total of 446 family caregivers of children with chronic diseases were interviewed, and they completed the Sociodemographic Variables Questionnaire for research on family caregivers of children with chronic sociodemographic diseases and four psychosocial measurement instruments for evaluating anxiety, depression, caregiver burden and quality of life.

Results

Based on the results of the first study, we created the Sociodemographic Variables Questionnaire (Q-SV) for research on family caregivers of children with chronic diseases, and it includes 17 items that assess demographic, medical, and family characteristics. The results of the second study showed that the 17 sociodemographic variables obtained in the validation by expert judges are useful for measuring and evaluating the relationship between psychosocial variables in families of children with chronic diseases.

Conclusions

Psychosocial and sociodemographic factors are relevant for the development of research processes for families that care for children with chronic diseases.

Clinical utility of the INECO Frontal Screening for detecting Mild Cognitive Impairment in Parkinson's disease

Cognitive deficits in Parkinson’s disease typically affect executive functions. Recently, the concept of Mild Cognitive Impairment (MCI) has been related to PD (PD-MCI). PD-MCI is considered a transition phase to Parkinson’s disease Dementia. Therefore, it is important to identify PD-MCI in a reliable way. Objective: To evaluate the sensitivity and specificity of the INECO Frontal Screening (IFS) in detecting cognitive deficits in PD-MCI. Additionally, we compare the IFS and the Addenbrook Cognitive Examination Revised (ACE-R) between three groups; PD-MCI, MCI, and controls. Methods: The IFS and ACE-R were administered to 36 patients with PD-MCI, 31 with MCI (amnestic-multidomain subtype) and 92 healthy controls. Sensitivity and specificity were determined using ROC analysis. The groups were compared using one-way analysis of variance. Results: The IFS had adequate accuracy in differentiating patients with PD-MCI from healthy controls (AUC=0.77, sensitivity=0.82, specificity=0.77), and good accuracy in differentiating PD-MCI from MCI patients (AUC=0.80, sensitivity=0.82, specificity=0.61). However the IFS had low accuracy in differentiating MCI patients from healthy controls (AUC=0.47, sensitivity=0.52, specificity=0.41). On the ACE-R, the PD-MCI group had low performance in Fluency and Language. Only patients with PD-MCI had difficulties on the IFS, specifically in inhibitory control and visual working memory. This dysexecutive profile explains the sensitivity and specificity values found in the IFS. Conclusion: The present study results suggest that the IFS is a suitable screening tool for exploring cognitive dysfunction in PD-MCI, especially in those patients with a dysexecutive profile.

Medical Cost to Treat Cervical Cancer Patients at a Social Security Third Level Oncology Hospital in Mexico City

Background:

Cervical Cancer (CC) is an important public health problem worldwide. In 2015, CC was the sixth leading cause of death for women aged 30-59 years in Mexico. Despite the importance of having high-quality and accurate estimates of CC treatment costs that can be used to effectively evaluate the impact of preventive programs, there is scarce information on this topic in Mexico.

Objective:

To estimate the treatment costs by stage diagnosis in patients with CC at a Mexican Social Security Institute (IMSS) oncology hospital in Mexico City.

Methods:

An observational retrospective study of the resources used to treat 346 women with CC was conducted. Medical charts were reviewed and relevant resource use information was extracted using a data collection instrument that was created based on treatment guidelines. Data were classified into nine cost categories to estimate the total cost per patient.

Results:

The mean age of patients in the study sample was 54.3 years (range: 41-67), and the average body mass index (BMI) was >26 kg/m². Among the participants, 37% were smokers, 39% had diabetes, and 56% had hypertension. The medical cost for stages I-IV ranged from $4,738 to $6,058 USD, with an estimated average cost of $5,114 USD.

Conclusion:

Total treatment costs per patient are high, especially since they were estimated considering only 7.5 months of treatment. This is the first study to estimate the annual cost to treat CC in Mexico and to additionally document the resource pattern use, cost by stage of cancer, and the distribution by cost categories.

Psychosocial factors related with caregiver burden among families of children with chronic conditions

BACKGROUND

The impact of looking after children who live with complex chronic conditions is a growing public health issue. However, it is unclear whether sociodemographic and psychosocial variables can be used to predict the burden on the caregiver and how the profiles of families of children with chronic diseases are defined and structured. The objective of this study was to identify multivariate sociodemographic and psychosocial variables as well as sociocultural and familial factors to analyze the caregiver burden of family caregivers of children with chronic diseases.

METHODS

A cross-sectional study was conducted involving 416 family caregivers of children with chronic diseases at the National Institute of Health in Mexico City. The participants responded to a questionnaire on sociodemographic variables and a battery of 7 instruments that examined caregiver burden, family support, parental stress, anxiety, support networks, family functioning, historic-psycho-socio-cultural premises and the World Health Organization Well-Being Index.

RESULTS

A multivariate analysis using hierarchical multiple regression models showed that the variables included in the psychosocial and sociodemographic profile as a whole explained 40% of the variance in caregiver burden, taking sociocultural historical premises, stressors and anxiety into account as positive individual predictors. Negative individual predictors for caregiver burden included upper secondary education, social support networks, family support, family functioning and well-being. The sociodemographic profiles of family caregivers were as follows: female (81.7%); mean age, 31.7 years (standard deviation [SD], 8 years); married (79.3%); nuclear family (60%); basic education (62.7%); unpaid work (66.3%); and a daily household income of approximately 4 USD (61.1%).

CONCLUSIONS

The caregiver burden of family caregivers of children with chronic diseases is defined and structured based on personal, family, and sociocultural factors. These features provide evidence to conduct research and implement intervention strategies with regard to families facing adversity, risk and vulnerability during a child's disease.

Estimating the prevalence of hepatitis C among intravenous drug users in upper middle income countries: A systematic review and meta-analysis

Aim

This systematic review and meta-analysis characterizes the prevalence of hepatitis C virus (HCV) infection among intravenous drug users (IDUs) in upper middle-income countries.

Methods

Five databases were searched from 1990–2016 for studies that took place in countries with a GDP per capita of $7,000 to $13,000 USD. The data extraction was performed based on information regarding prevalence, sample size, age of participants, duration of intravenous drug use (IDU), recruitment location, dates of data collection, study design, sampling scheme, type of tests used in identifying antibody reactivity to HCV, and the use of confirmatory tests. The synthesis was performed with a random effects model. The Cochrane statistical Q-test was used to evaluate the statistical heterogeneity of the results.

Results

The 33 studies included in the analysis correspond to a sample of seven countries and 23,342 observations. The point prevalence value estimates and confidence intervals of the random effects model were 0.729 and 0.644–0.800, respectively for all seven countries, and were greatest for China (0.633; 0.522–0.732) as compared to Brazil (0.396; 0.249–0.564). Prevalence for Montenegro (0.416; 0.237–0.621) and Malaysia (0.475; 0.177–0.792) appear to be intermediate. Mexico (0.960) and Mauritania (0.973) had only one study with the largest prevalence. A clear association was not observed between age or duration of IDU and prevalence of HCV, but the data from some groups may indicate a possible relationship. The measures of heterogeneity (Q and I2) suggest a high level of heterogeneity in studies conducted at the country level and by groups of countries.

Conclusions

In this systematic review and meta-analysis, we found that the pooled prevalence of HCV was high (0.729) among a group of seven upper middle income countries. However, there was significant variation in the prevalence of HCV observed in China (0.633) and Brazil (0.396).

Out-of-pocket expenditures and care time for children with Down Syndrome: A single-hospital study in Mexico City

Aim

To examine the burden of out-of-pocket household expenditures and time spent on care by families responsible for children with Down Syndrome (DS).

Methods

A cross-sectional analysis was performed after surveying families of children with DS. The children all received medical care at the Hospital Infantil de México Federico Gomez (HIMFG), a National Institute of Health. Data were collected on out-of-pocket household expenditures for the medical care of these children. The percentage of such expenditure was calculated in relation to available household expenditure (after subtracting the cost of food/housing), and the percentage of households with catastrophic expenditure. Finally, the time spent on the care of the child was assessed.

Results

The socioeconomic analysis showed that 67% of the households with children with DS who received medical care in the HIMFG were within the lower four deciles (I-IV) of expenses, indicating a limited ability to pay for medical services. Yearly out-of-pocket expenditures for a child with DS represented 27% of the available household expenditure, which is equivalent to $464 for the United States dollars (USD). On average, 33% of families with DS children had catastrophic expenses, and 46% of the families had to borrow money to pay for medical expenses. The percentage of catastrophic expenditure was greater for a household with children aged five or older compared with households with younger children. The regression analysis revealed that the age of the child is the most significant factor determining the time spent on care.

Conclusions

Some Mexican families of children with DS incur substantial out-of-pocket expenditures, which constitute an economic burden for families of children who received medical care at the HIMFG.

Factors associated with anxiety in family caregivers of children with chronic diseases

BACKGROUND

Currently, information on factors associated with anxiety in family caregivers of children with chronic diseases is unavailable, indicating a significant gap in the literature. Therefore, this study aims to identify the psychosocial and sociodemographic variables associated with anxiety in family caregivers of children with chronic diseases.

METHODS

In 2018, a nonprobability sample of 446 family caregivers was recruited at the National Institute of Health in Mexico City. The participants completed a sociodemographic variable questionnaire, clinical questions, and 18 psychosocial assessment scales, including a scale to assess family caregiver anxiety.

RESULTS

Family caregiver anxiety was correlated with almost all psychosocial variables and one out of three clinical variables but with none of the sociodemographic variables. Furthermore, a multiple linear regression model with five psychosocial variables was established to predict family caregiver anxiety.

CONCLUSIONS

Some psychosocial variables have effects on caregiver anxiety that are relevant for interventions. Clinical interventions should be implemented based on the psychosocial variables associated with family caregiver anxiety.

Validity and reliability of the Beck Depression Inventory II (BDI-II) in family caregivers of children with chronic diseases

BACKGROUND

Information on the psychometric properties of the Beck Depression Inventory II (BDI-II) in family caregivers of children with chronic diseases is currently unavailable, indicating a significant gap in the literature. Therefore, we investigated 1) which of the five evaluated measurement models had the best fit, 2) the scale's reliability, and 3) the scale's convergent validity.

METHODS

In 2018, a cross-sectional ex post facto study with non-probability convenience sampling was conducted in 446 family caregivers of children with chronic diseases at the National Institute of Health in Mexico City; the family caregivers responded to the BDI-II and a battery of instruments measuring anxiety, caregiver burden, parental stress, well-being, and quality of life. A confirmatory factor analysis was conducted to determine the fit of the five models. Cronbach's alpha and composite reliability were calculated to assess the scale's reliability, and Spearman´s rank correlation was used to investigate the scale's convergent validity.

RESULTS

This study provided evidence that the two-factor somatic-affective and cognitive model had the best fit. The BDI-II demonstrated adequate reliability and evidence of convergent validity, as the BDI-II factors were positively correlated with anxiety, caregiver burden, and parental stress and negatively correlated with well-being and quality of life.

CONCLUSIONS

The findings reveal that the BDI-II is a valid, reliable, and culturally relevant instrument to measure depression in family caregivers of children with chronic diseases.

Validity and reliability of the Mexican resilience measurement scale in families of children with chronic conditions

Background

The resilience to face disease is a process of positive adaptation despite the loss of health. It involves developing vitality and skills to overcome the negative effects of adversity, risks, and vulnerability caused by disease. In Mexico, the Mexican Resilience Measurement Scale (RESI-M) has been validated with a general population and has a five-factor structure. However, this scale does not allow evaluation of resilience in specific subpopulations, such as caregivers.

Method

This study investigated the psychometric properties of RESI-M in 446 family caregivers of children with chronic diseases. A confirmatory factor analysis (CFA) was performed, internal consistency values were calculated using Cronbach’s alpha coefficient, and mean comparisons were determined using t-tests.

Results

The expected five-factor model showed an adequate fit with the data based on a maximum likelihood test. The internal consistency for each factor ranged from .76 to .93, and the global internal consistency was .95. No average difference in RESI-M and its factors was found between women and men.

Conclusion

The RESI-M showed internal consistency and its model of five correlated factors was valid among family caregivers of children with chronic diseases.