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Ripoll J, Chela-Alvarez X, Briones-Vozmediano E, Fiol de-Roque MA, Campos RZ, Ricci-Cabello I, Llobera J, Calafat-Villalonga C, Serrano-Ripoll MJ. Correction to: Impact of COVID-19 on mental health of health care workers in Spain: a mix-methods study. BMC Public Health 2024; 24:880. [PMID: 38515039 PMCID: PMC10958946 DOI: 10.1186/s12889-024-18312-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024] Open
Affiliation(s)
- J Ripoll
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB). Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
| | - X Chela-Alvarez
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain.
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB). Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain.
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain.
| | - E Briones-Vozmediano
- Departamento de Enfermería y Fisioterapia. Grupo de estudios en sociedad, salud, educación y cultura (GESEC). Universidad de Lleida.Grup de Recerca en Cures en Salut (GRECS), Institut de Recerca Biomèdica (IRB) de Lleida, Lleida, 25001, Spain
| | - M A Fiol de-Roque
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB). Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
| | - R Zamanillo- Campos
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB). Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
| | - I Ricci-Cabello
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB). Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
| | - J Llobera
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB). Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
| | - C Calafat-Villalonga
- Department of Psychology, University of the Balearic Islands, Palma, 07122, Spain
| | - M J Serrano-Ripoll
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB). Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
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Ripoll J, Chela-Alvarez X, Briones-Vozmediano E, Fiol de-Roque MA, Zamanillo-Campos R, Ricci-Cabello I, Llobera J, Calafat-Villalonga C, Serrano-Ripoll MJ. Impact of COVID-19 on mental health of health care workers in Spain: a mix-methods study. BMC Public Health 2024; 24:463. [PMID: 38355471 PMCID: PMC10865523 DOI: 10.1186/s12889-024-17979-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/04/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Spain's lockdown measures couldn't prevent the severe impact of the COVID-19 first wave, leading to high infections, deaths, and strain on healthcare workers (HCWs). This study aimed to explore the mental health impact on HCWs in the Balearic Islands during the initial months of the pandemic, the influencing factors, and the experiences of those in a COVID-19 environment. METHODS Using a mixed-methods approach, the study encompassed quantitative and qualitative elements. Cross-sectional survey data from April to June 2020 comprised HCWs who were emailed invitations. The survey covered demographics, work, clinical and COVID-19 variables, along with psychological distress and PTSD symptoms, using validated measures. Additionally, semi-structured interviews with HCWs offered qualitative insights. RESULTS Three hundred thirty-six HCWs averaging 46.8 years, mainly women (79.2%), primarily nurses in primary care with over 10 years of experience. Anxiety symptoms were reported by 28.8%, 65.1% noted worsened sleep quality, and 27.7% increased psychoactive drug usage. Psychological distress affected 55.2%, while 27.9% exhibited PTSD symptoms. Gender, age, experience, COVID-19 patient contact, and workload correlated with distress, PTSD symptoms, sleep quality, and psychoactive drug usage. Interviews uncovered discomfort sources, such as fear of infection and lack of control, leading to coping strategies like information avoidance and seeking support. LIMITATIONS Static cross-sectional design, non-probabilistic sample, and telephone interviews affecting non-verbal cues, with interviews conducted during early pandemic lockdown. CONCLUSIONS HCWs faced significant psychological distress during the pandemic's first wave, underscoring the necessity for robust support and resources to counteract its impact on mental health.
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Affiliation(s)
- J Ripoll
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
| | - X Chela-Alvarez
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain.
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain.
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain.
| | - E Briones-Vozmediano
- Departamento de Enfermería y Fisioterapia Grupo de estudios en sociedad, salud, educación y cultura (GESEC), Universidad de Lleida.Grup de Recerca en Cures en Salut (GRECS), Institut de Recerca Biomèdica (IRB) de Lleida, Lleida, 25001, Spain
| | - M A Fiol de-Roque
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
| | - R Zamanillo-Campos
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
| | - I Ricci-Cabello
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
| | - J Llobera
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
| | - C Calafat-Villalonga
- Department of Psychology, University of the Balearic Islands, Palma, 07122, Spain
| | - M J Serrano-Ripoll
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
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Aguilar-Latorre A, Oliván-Blázquez B, Porroche-Escudero A, Serrano-Ripoll MJ, Magallón-Botaya R. Editorial: Mental health in primary health care. Front Psychol 2023; 14:1190410. [PMID: 37265950 PMCID: PMC10230021 DOI: 10.3389/fpsyg.2023.1190410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/02/2023] [Indexed: 06/03/2023] Open
Affiliation(s)
- Alejandra Aguilar-Latorre
- Aragonese Primary Care Research Group (GAIAP), Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Health Institute, Madrid, Spain
| | - Bárbara Oliván-Blázquez
- Aragonese Primary Care Research Group (GAIAP), Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Health Institute, Madrid, Spain
| | - Ana Porroche-Escudero
- Centre for Health Inequalities Research, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
| | - María J. Serrano-Ripoll
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Health Institute, Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Spain
| | - Rosa Magallón-Botaya
- Aragonese Primary Care Research Group (GAIAP), Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Health Institute, Madrid, Spain
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
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Garcia-Toro M, Aguilar-Latorre A, Garcia A, Navarro-Guzmán C, Gervilla E, Seguí A, Gazquez F, Marino JA, Gomez-Juanes R, Serrano-Ripoll MJ, Oliván-Blázquez B, Garcia-Campayo J, Maloney S, Montero-Marin J. Mindfulness skills and experiential avoidance as therapeutic mechanisms for treatment-resistant depression through mindfulness-based cognitive therapy and lifestyle modification. Front Psychol 2023; 14:1008891. [PMID: 36968708 PMCID: PMC10033944 DOI: 10.3389/fpsyg.2023.1008891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 02/15/2023] [Indexed: 03/11/2023] Open
Abstract
Background/objectiveThe COVID-19 pandemic and consequent physical distancing has made it difficult to provide care for those with Treatment-Resistant Depression (TRD). As a secondary analysis of a clinical trial, the aim of this study was to explore potential mechanisms through which three online-delivered approaches, added to treatment as usual, improve depressive symptoms in TRD patients.MethodsThe three approaches included (a) Minimal Lifestyle Intervention (MLI), (b) Mindfulness-Based Cognitive Therapy (MBCT), and (c) Lifestyle Modification Program (LMP). Sixty-six participants with TRD completed assessments pre-post intervention (mindfulness skills [FFMQ]; self-compassion [SCS]; and experiential avoidance [AAQ-II]) and pre-intervention to follow-up (depressive symptoms [BDI-II]). Data were analyzed using within-subjects regression models to test mediation.ResultsMindfulness skills mediated the effect of MBCT on depressive symptoms (ab = −4.69, 95% CI = −12.93 to−0.32), whereas the lack of experiential avoidance mediated the effect of LMP on depressive symptoms (ab = −3.22, 95% CI = −7.03 to−0.14).ConclusionStrengthening mindfulness skills and decreasing experiential avoidance may promote recovery in patients with TRD, MBCT, and LMP have demonstrated that they may help increase mindfulness skills and decrease experiential avoidance, respectively. Future work will need to unpick the components of these interventions to help isolate active ingredients and increase optimization.
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Affiliation(s)
- Mauro Garcia-Toro
- University Institute of Health Science Research (IUNICS), University of the Balearic Islands, Palma, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Department of Medicine, University of the Balearic Islands, Palma, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Health Institute, Madrid, Spain
| | - Alejandra Aguilar-Latorre
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Health Institute, Madrid, Spain
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- *Correspondence: Alejandra Aguilar-Latorre,
| | - Aurora Garcia
- University Institute of Health Science Research (IUNICS), University of the Balearic Islands, Palma, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | | | - Elena Gervilla
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Department of Psychology, University of the Balearic Islands, Palma, Spain
| | - Andrea Seguí
- University Institute of Health Science Research (IUNICS), University of the Balearic Islands, Palma, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Francisco Gazquez
- University Institute of Health Science Research (IUNICS), University of the Balearic Islands, Palma, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Jose Antonio Marino
- University Institute of Health Science Research (IUNICS), University of the Balearic Islands, Palma, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Rocío Gomez-Juanes
- University Institute of Health Science Research (IUNICS), University of the Balearic Islands, Palma, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - María J. Serrano-Ripoll
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Health Institute, Madrid, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Spain
| | - Bárbara Oliván-Blázquez
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Health Institute, Madrid, Spain
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Javier Garcia-Campayo
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Health Institute, Madrid, Spain
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
| | - Shannon Maloney
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
| | - Jesús Montero-Marin
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
- Teaching, Research and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health-CIBERESP), Madrid, Spain
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Garcia A, Yáñez AM, Bennasar-Veny M, Navarro C, Salva J, Ibarra O, Gomez-Juanes R, Serrano-Ripoll MJ, Oliván B, Gili M, Roca M, Riera-Serra P, Aguilar-Latorre A, Montero-Marin J, Garcia-Toro M. Efficacy of an adjuvant non-face-to-face multimodal lifestyle modification program for patients with treatment-resistant major depression: A randomized controlled trial. Psychiatry Res 2023; 319:114975. [PMID: 36442318 DOI: 10.1016/j.psychres.2022.114975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 11/18/2022] [Accepted: 11/20/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND The high prevalence of depression is partly attributable to the poor response of patients to first-line antidepressants. Multimodal programs that promote a healthy lifestyle are successful in treating depression when used as a complementary therapy, but their medium- and long-term benefits have not been demonstrated for patients with treatment-resistant depression (TRD). The main aim of this study was to compare the effectiveness of a lifestyle modification program (LMP) with mindfulness-based cognitive therapy (MBCT) and a placebo-control (written suggestions for lifestyle changes) in Spanish patients with TRD. METHODS This controlled clinical trial randomized 94 patients with TRD into 3 arms. The primary outcome was the Beck Depression Inventory-II (BDI-II) score at baseline, 2, 6 and 12 months. The secondary outcomes were changes in scores that evaluated quality-of-life, adherence to the Mediterranean diet, physical activity, and social support. RESULTS Relative to the placebo group, the LMP and MBCT groups had significantly better quality of life (p = 0.017; p = 0.027), and the LMP group had significantly better adherence to the Mediterranean diet (p<0.001) and reduced use of antidepressants (p = 0.036). However, the three groups showed no significant differences in BDI-II score. LIMITATIONS Only about half of the planned 180 patients were recruited, in part due to the COVID-19 pandemic. CONCLUSIONS There was no evidence that the LMP treatment significantly reduced symptoms of depression relative to the other groups during the COVID-19 lockdown.
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Affiliation(s)
- Aurora Garcia
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain
| | - Aina M Yáñez
- Health Research Institute of the Balearic Islands (IdISBa), Spain; Department of Nursing and Physiotherapy and Research Group on Global Health and Human Development, UIB
| | - Miquel Bennasar-Veny
- Health Research Institute of the Balearic Islands (IdISBa), Spain; Department of Nursing and Physiotherapy and Research Group on Global Health and Human Development, UIB; CIBER de Epidemiologíública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - Capilla Navarro
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain
| | - Joan Salva
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain; Department of Medicine, University of the Balearic Islands, E-07122 Palma, Spain
| | - Olga Ibarra
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain
| | - Rocío Gomez-Juanes
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain; Department of Medicine, University of the Balearic Islands, E-07122 Palma, Spain
| | - María J Serrano-Ripoll
- Primary Care Research Unit of Majorca, Balearic Islands Health Services and Department of Psychology, UIB
| | - Bárbara Oliván
- Department of Psychology and Sociology, University of Zaragoza. Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
| | - Margalida Gili
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain
| | - Miquel Roca
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain; Department of Medicine, University of the Balearic Islands, E-07122 Palma, Spain
| | - Pau Riera-Serra
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain
| | | | - Jesús Montero-Marin
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK; Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Mauro Garcia-Toro
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain; Department of Medicine, University of the Balearic Islands, E-07122 Palma, Spain
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Aguilar-Latorre A, Pérez Algorta G, Navarro-Guzmán C, Serrano-Ripoll MJ, Oliván-Blázquez B. Effectiveness of a lifestyle modification programme in the treatment of depression symptoms in primary care. Front Med (Lausanne) 2022; 9:954644. [PMID: 35957845 PMCID: PMC9361711 DOI: 10.3389/fmed.2022.954644] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/07/2022] [Indexed: 11/19/2022] Open
Abstract
Background Depression symptoms are prevalent in the general population, and their onset and continuation may be related to biological and psychosocial factors, many of which are related to lifestyle aspects. Health promotion and lifestyle modification programmes (LMPs) may be effective on reducing the symptoms. The objective of this study was to analyse the clinical effectiveness of a LMP and a LMP plus Information and Communication Technologies, when compared to Treatment as Usual (TAU) over 6 months. The interventions were offered as an adjuvant treatment delivered in Primary Healthcare Centers (PHCs) for people with depression symptoms. Methods We conducted an open-label, multicentre, pragmatic, randomized clinical trial. Participants were recruited from several PHCs. Those participants visiting general practitioner for any reason, who also met the inclusion criteria (scoring 10 to 30 points on the Beck II Self-Applied Depression Inventory) were invited to take part in the study. TAU+LMP consisted of six weekly 90-min group sessions focused on improving lifestyle. TAU+LMP + ICTs replicated the TAU+LMP format, plus the addition of a wearable smartwatch to measure daily minutes walked and sleep patterns. A total of 188 participants consented to participate in the study and were randomized. We used linear mixed models, with a random intercept and an unstructured covariance to evaluate the impact of the interventions compared to TAU. Results Both interventions showed a statistically significant reduction on depressive symptoms compared to TAU (TAU+LMP vs. TAU slope difference, b = −3.38, 95% CI= [−5.286, −1.474] p = 0.001 and TAU+LMP+ICTs vs. TAU slope difference, b = −4.05, 95% CI = [−5.919, −2.197], p < 0.001). These reductions imply a moderate effect size. In the TAU+LMP+ICTs there was a significant increase regarding minutes walking per week (b = 99.77) and adherence to Mediterranean diet (b = 0.702). In the TAU+LMP there was a significant decrease regarding bad sleep quality (b = −1.24). Conclusion TAU+LMPs administered in PHCs to people experiencing depression symptoms were effective on reducing these symptoms compared to TAU. They also have a positive impact on changing several lifestyle factors. These findings indicate that these interventions can be promising strategies for PHCs.
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Affiliation(s)
- Alejandra Aguilar-Latorre
- Primary Healthcare Center Arrabal, Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
| | - Guillermo Pérez Algorta
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
| | | | - María J. Serrano-Ripoll
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Spain
- Research in Preventive Activities and Promotion and in Cancer Illes Balears (GRAPP-CAIB), Balearic Islands Health Research Institute (IdISBa), Palma, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- *Correspondence: María J. Serrano-Ripoll
| | - Bárbara Oliván-Blázquez
- Primary Healthcare Center Arrabal, Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
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Serrano-Ripoll MJ, Llobera J, Valderas JM, de Labry Lima AO, Fiol-deRoque MA, Ripoll J, Ricci-Cabello I. Cross-Cultural Adaptation, Validation, and Piloting of the Patient Reported Experiences and Outcomes of Safety in Primary Care Questionnaire for Its Use in Spain. J Patient Saf 2022; 18:102-110. [PMID: 35188925 DOI: 10.1097/pts.0000000000000819] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study aimed to cross-culturally adapt, validate, and pilot the Patient Reported Experiences and Outcomes of Safety in Primary Care questionnaire for its use in Spain. METHODS After setting up an expert panel to determine its content validity, the questionnaire was translated and back-translated, and subjected to cognitive testing. The questionnaire was piloted in a cross-sectional study in 10 primary health care centers in Spain. Fifty patients per center completed the questionnaire while waiting for an appointment. We estimated (i) the acceptability of the questionnaire (response rate), (ii) scores distribution (floor and ceiling effects), (iii) internal consistency (Cronbach α), and (iv) construct validity (exploratory factor analyses and correlation between scales). To examine patients' evaluations of patient safety, we followed a mixed-methods approach: (i) statistical analyses at the scale and item levels based on responses to standardized items and (ii) qualitative content analysis based on responses to open-ended questions. RESULTS Complete data were collected from 493 patients (participation rate, 77%). A ceiling effect was observed for 3 scales ("safety problems," "harm severity," "harm needs"). The internal consistency was adequate (α > 0.7) for the majority of scales. Exploratory factor analysis and correlation between scales suggested an appropriate construct validity. Two hundred twenty-six (45.8%) respondents experienced at least 1 safety problem, and 109 (23.2%) reported harm in the previous 12 months. CONCLUSIONS The multidimensional primary health care patient safety instrument Patient Reported Experiences and Outcomes of Safety in Primary Care is now available for its use in Spain. Initial testing demonstrates its potential for use in primary care. Future developments will further address its use in actual clinical practice.
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Affiliation(s)
| | | | - José M Valderas
- Health Services and Policy Research Group, University of Exeter Collaboration for Academic Primary Care, University of Exeter Medical School, Exeter, United Kingdom
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Serrano-Ripoll MJ, Zamanillo-Campos R, Castro A, Fiol-de Roque MA, Ricci-Cabello I. Insomnia and sleep quality in healthcare workers fighting against COVID-19: a systematic review of the literature and meta-analysis. Actas Esp Psiquiatr 2021; 49:155-179. [PMID: 34195971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 07/01/2021] [Indexed: 06/13/2023]
Abstract
The COVID-19 pandemic has the potential to significant- ly affect the mental health of healthcare workers, who stand in the frontline of this crisis. Insomnia is often related to exposure to stressful situations, such as the current health crisis, as well as other mental disorders, physical conditions and work-related problems. The objectives of this systematic review were: 1) to examine the impact of the current health pandemic produced by COVID-19 on insomnia and sleep quality of health professionals, and 2) to identify risk factors associated with insomnia. After a literature search in MEDLINE, EMBASE, and PsycINFO, 18 relevant studies were identified. The prevalence of insomnia estimated by random effects meta-analysis was 38% (95%CI= 37 to 39%), being slightly higher in women (29%, 95%CI= 27% to 30%) than in men (24%, 95%CI= 21 to 27%). The main risk factor associated with insomnia was working in a high-risk environment, followed by female sex and having a lower educational level. The high figures of self-reported insomnia and poor sleep quality observed indicate the need to develop interventions aimed at mitigating and caring for the mental health of healthcare workers fighting against this pandemic.
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Affiliation(s)
- María J Serrano-Ripoll
- Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa). Carretera de Valldemossa, 79 Hospital Universitario Son Espases. Edificio S. 07120 Palma de Mallorca. Islas Baleares. España. Servicio de Salud de las Islas Baleares, Unidad de Investigación de Atención Primaria de Mallorca, Calle Escola Graduada, 3, 3o. 07002, Palma, Islas Baleares, España Universidad de las Islas Baleares (UIB), Departamento de Psicología, Carretera de Valldemossa, km 7.5. Edificio Científico-Técnico. 07122, Palma, Islas Baleares, España
| | - Rocío Zamanillo-Campos
- Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa). Carretera de Valldemossa, 79 Hospital Universitario Son Espases. Edificio S. 07120 Palma de Mallorca. Islas Baleares. España. Universidad Internacional de Valencia (VIU), Departamento de Salud, Calle Pintor Sorolla, 21. 46002, Valencia, EspañaServicio de Salud de las Islas Baleares, Unidad de Investigación de Atención Primaria de Mallorca, Calle Escola Graduada, 3, 3o. 07002, Palma, Islas Baleares, España
| | - Adoración Castro
- Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa). Carretera de Valldemossa, 79 Hospital Universitario Son Espases. Edificio S. 07120 Palma de Mallorca. Islas Baleares. España Instituto Universitario de Investigación en Ciencias de la Salud (IUNICS), Universidad de las Islas Baleares. Carretera de Valldemossa, km 7,5. Edificio Científico-Técnico. 07122 Palma. Islas Baleares. España
| | - María A Fiol-de Roque
- Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa). Carretera de Valldemossa, 79 Hospital Universitario Son Espases. Edificio S. 07120 Palma de Mallorca. Islas Baleares. España. Servicio de Salud de las Islas Baleares, Unidad de Investigación de Atención Primaria de Mallorca, Calle Escola Graduada, 3, 3o. 07002, Palma, Islas Baleares, España
| | - Ignacio Ricci-Cabello
- Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa). Carretera de Valldemossa, 79 Hospital Universitario Son Espases. Edificio S. 07120 Palma de Mallorca. Islas Baleares. España. Servicio de Salud de las Islas Baleares, Unidad de Investigación de Atención Primaria de Mallorca, Calle Escola Graduada, 3, 3o. 07002, Palma, Islas Baleares, España Ciber de Epidemiología y Salud Pública (CIBERESP), Madrid, España
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García-Toro M, Vicens-Pons E, Gili M, Roca M, Serrano-Ripoll MJ, Vives M, Leiva A, Yáñez AM, Bennasar-Veny M, Oliván-Blázquez B. Obesity, metabolic syndrome and Mediterranean diet: Impact on depression outcome. J Affect Disord 2016; 194:105-8. [PMID: 26807670 DOI: 10.1016/j.jad.2015.12.064] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 12/10/2015] [Accepted: 12/26/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Obesity, metabolic syndrome (MetS) and low adherence to Mediterranean diet are frequent in major depression patients and have been separately related with prognosis. The aim of this study is to analyse their predictive power on major depression outcome, at 6 and 12 months. METHODS 273 Major depressive patients completed the Beck Depression Inventory for depressive symptoms and the 14-item Mediterranean diet adherence score. MetS was diagnosed according to the International Diabetes Federation (IDF). RESULTS At the baseline Mediterranean diet adherence was inversely associated with depressive symptoms (p=0.007). Depression response was more likely in those patients with normal weight (p=0.006) and not MetS (p=0.013) but it was not associated with Mediterranean diet adherence (p=0.625). Those patients with MetS and obesity were less likely to improve symptoms of depression than patients with obesity but not MetS. CONCLUSIONS Obesity and MetS, but not low adherence to the Mediterranean diet at baseline, predicted a poor outcome of depression at 12 months. Our study suggests that MetS is the key factor that impacts negatively in depression prognosis, rather than obesity or diet. If this finding is confirmed, clinicians should be aware about MetS diagnosis and treatment in overweight depressed patients, especially if outcome is not being satisfactory enough.
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Affiliation(s)
- M García-Toro
- University of Balearic Islands, Spain; Primary Care Prevention and Health Promotion Research Network, Spain
| | - E Vicens-Pons
- Primary Care Prevention and Health Promotion Research Network, Spain; Psychiatric Service, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - M Gili
- University of Balearic Islands, Spain; Primary Care Prevention and Health Promotion Research Network, Spain
| | - M Roca
- University of Balearic Islands, Spain; Primary Care Prevention and Health Promotion Research Network, Spain
| | | | - M Vives
- University of Balearic Islands, Spain; Primary Care Prevention and Health Promotion Research Network, Spain
| | - A Leiva
- Primary Care Research Unit of Mallorca, Health Services-IbSalut, Instituto de Investigación Sanitaria, Spain
| | - A M Yáñez
- Instituto de Investigación Sanitaria de Palma, IdISPa, Spain
| | - M Bennasar-Veny
- University of Balearic Islands, Spain; Department of Nursing, School of Nursing and Physiotherapy, University of Balearic Islands, Spain
| | - B Oliván-Blázquez
- Primary Care Prevention and Health Promotion Research Network, Spain; Department of Psychology and Sociology, University of Zaragoza, Spain
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