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Mira JJ, Cobos A, Martínez García O, Bueno Domínguez MJ, Astier-Peña MP, Pérez Pérez P, Carrillo I, Guilabert M, Perez-Jover V, Fernandez C, Vicente MA, Lahera-Martin M, Silvestre Busto C, Lorenzo Martínez S, Sanchez Martinez A, Martin-Delgado J, Mula A, Marco-Gomez B, Abad Bouzan C, Aibar-Remon C, Aranaz-Andres J. An Acute Stress Scale for Health Care Professionals Caring for Patients With COVID-19: Validation Study. JMIR Form Res 2021; 5:e27107. [PMID: 33687343 PMCID: PMC7945973 DOI: 10.2196/27107] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/08/2021] [Accepted: 02/12/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has affected the response capacity of the health care workforce, and health care professionals have been experiencing acute stress reactions since the beginning of the pandemic. In Spain, the first wave was particularly severe among the population and health care professionals, many of whom were infected. These professionals required initial psychological supports that were gradual and in line with their conditions. OBJECTIVE In the early days of the pandemic in Spain (March 2020), this study aimed to design and validate a scale to measure acute stress experienced by the health care workforce during the care of patients with COVID-19: the Self-applied Acute Stress Scale (EASE). METHODS Item development, scale development, and scale evaluation were considered. Qualitative research was conducted to produce the initial pool of items, assure their legibility, and assess the validity of the content. Internal consistency was calculated using Cronbach α and McDonald ω. Confirmatory factor analysis and the Mann-Whitney-Wilcoxon test were used to assess construct validity. Linear regression was applied to assess criterion validity. Back-translation methodology was used to translate the scale into Portuguese and English. RESULTS A total of 228 health professionals from the Spanish public health system responded to the 10 items of the EASE scale. Internal consistency was .87 (McDonald ω). Goodness-of-fit indices confirmed a two-factor structure, explaining 55% of the variance. As expected, the highest level of stress was found among professionals working in health services where a higher number of deaths from COVID-19 occurred (P<.05). CONCLUSIONS The EASE scale was shown to have adequate metric properties regarding consistency and construct validity. The EASE scale could be used to determine the levels of acute stress among the health care workforce in order to give them proportional support according to their needs during emergency conditions, such as the COVID-19 pandemic.
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Affiliation(s)
- Jose Joaquin Mira
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, Alicante, Spain
- Department of Health Psychology, Miguel Hernandez University, Elche, Spain
- European Research Network on Second Victims (COST Action CA-19113), Alicante, Spain
| | - Angel Cobos
- Intensive Care Unit, San Cecilio Clinical University Hospital, Granada, Spain
| | | | | | | | | | - Irene Carrillo
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, Alicante, Spain
- Department of Health Psychology, Miguel Hernandez University, Elche, Spain
- European Research Network on Second Victims (COST Action CA-19113), Alicante, Spain
| | - Mercedes Guilabert
- Department of Health Psychology, Miguel Hernandez University, Elche, Spain
| | | | - Cesar Fernandez
- Telematics Engineering Area, Miguel Hernandez University, Elche, Spain
| | | | | | | | - Susana Lorenzo Martínez
- Department of Quality and Patient Management, Alcorcon Foundation University Hospital, Madrid, Spain
| | | | - Jimmy Martin-Delgado
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, Alicante, Spain
- European Research Network on Second Victims (COST Action CA-19113), Alicante, Spain
| | - Aurora Mula
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, Alicante, Spain
| | | | | | - Carlos Aibar-Remon
- Department of Preventive Medicine, Lozano Blesa Univerisity Clinical Hospital, Zaragoza, Spain
| | - Jesus Aranaz-Andres
- Department of Preventive Medicine, Ramón y Cajal University Hospital, Madrid, Spain
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Fernández Urrusuno R, Montero Balosa MC, Pérez Pérez P, Pascual de la Pisa B. Compliance with quality prescribing indicators in terms of their relationship to financial incentives. Eur J Clin Pharmacol 2013; 69:1845-53. [PMID: 23743780 DOI: 10.1007/s00228-013-1542-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Accepted: 05/21/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To develop quality prescribing indicators for general practitioners (GPs) who are non-monitored and not included in pay-for-performance programs, and to determine compliance with incentivized and non-incentivized indicators. STUDY DESIGN Descriptive cross sectional study. SETTING Aljarafe Primary Health Care Area (Andalusian Public Health Care Service, Spain), a rural and suburban area with a population of 323,857 inhabitants. Health assistance in this area is provided by 176 GPs in 37 health centers. Prescribing indicators were developed by a multidisciplinary group using a qualitative technique based on consensus. The members of the consensus group searched for updated recommendations focused on clinical evidence. Prescribing data were obtained from the computerised pharmacy records of reimbursed drugs and clinical data from the electronic clinical databases and hospital admission records. RESULTS Fourteen indicators based on the selection of drugs of different therapeutic groups or linked to patient´s clinical information were designed. The compliance with indicators based on the selection of drugs linked to financial incentives was higher than that of indicators not linked to financial incentives. The compliance with indicators based on clinical information varied widely. Inappropriate prescribing ranged from 7 %, in the use of long-acting beta-agonists in asthma, to 86 % in the use of drugs for the prevention of osteoporotic fractures in young women. CONCLUSIONS This study shows better compliance by GPs with indirect and incentivized quality prescribing indicators, included in pay-for-performance programs, compared with not-incentivized indicators based on the relative use of drugs and on the appropriateness prescribing.
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Affiliation(s)
- Rocío Fernández Urrusuno
- Service of Pharmacy, Aljarafe-Sevilla Norte Primary Health Care Area, Distrito Sanitario Aljarafe; Avda de las Américas s/n, 41927, Mairena del Aljarafe, Seville, Spain,
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