Waterpipe use among adolescents. Possible implications and related variables

Substance use in waterpipe (generally tobacco or cannabis) constitutes an increasingly popular practice. It has become an emerging public health problem, with serious consequences at both pulmonary and addiction levels. Despite the growing concern it raises, few studies have been carried out in Spain to analyze this new practice from an early age. The aim of this study is to have new data about waterpipe use among adolescents and to analyze its possible implications and related variables. A survey was conducted among secondary school students from the Galician community. A total of 7,613 students aged 12-18 years (M = 14.97; SD = 1.69) participated. The CRAFFT, the AUDIT and the CAST were used to screen the risky use of other substances. The rates of waterpipe tobacco and cannabis use are at worrying levels (19.4% and 8.5%, respectively, for the last year), with significantly higher rates of risky substance use, drunkenness and binge drinking. The low perception risk is striking. Waterpipe use is a widespread practice in adolescence. In addition to serious health implications, is a clear indicator of a problematic underlying consumption. The low perception of risk, the "botellón" or the lack of family control are elements to take into account in community prevention.

Assessment of validity and comparison of two Spanish versions of the Geriatric Depression Scale

Introduction

The Geriatric Depression Scale is an instrument used to identify depression in people of an older age. The original English version of this scale has been translated into Spanish (GDS-VE); two shorter versions of 5- (GDS-5) and 15-items (GDS-15) have been developed.

Aim of the study

To assess the validity and compare the 5- and 15-item Spanish versions of the GDS among the Spanish population.

Materials and methods

573 Galicia residents aged >50 years participated in this study. The following instruments were applied: the 19-item Control, Autonomy, Self-Realization and Pleasure scale, the Subjective Memory Complaints Questionnaire, the Mini-Mental State Examination test, the GDS-5, and the GDS-15.

Results

We found differences in total score between GDS-5 and GDS-15 regarding the variable sex. Internal reliability for GDS-5 and GDS-15 was 0.495 and 0.715, respectively. Sensitivity and specificity for GDS-5 - with a cut-off value of 1 - was 0.517 and 0.650, respectively; for GDS-15 - with a cut-off value of 3 points - sensitivity was 0.755 and specificity 0.668. GDS-5 has a ROC curve of 0.617 and GDS-15 of 0.764.

Conclusion

GDS-15, and to a greater extent GDS-5, should be revised or even reformulated to improve their diagnostic usefulness by choosing higher discriminative ability items or even include new items with greater sensitivity that consider currently prevailing psychosocial factors.

A systematic review evaluating loneliness assessment instruments in older adults

Introduction and objectives

The experiences and changes that come along with old age may lead to a feeling of loneliness, usually followed by negative physical and mental manifestations. In this systematic review, we evaluated the existing tools to assess loneliness in older adults.

Methods

We performed a literature search in the Web of Science, Medline, and PsycINFO, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. After, we examined the psychometric properties of the instruments with a focus on reliability, validity, and main conclusions.

Results

We included 27 articles published between 1996 and 2021.

Conclusion

To date, there are few instruments to assess loneliness in older adults. In general, they present adequate psychometric properties, although it is true that some scales show somewhat low levels of reliability and validity.

Positive and Negative Feelings among Spanish Young-Old and Old-Old during the Lockdown of the COVID-19 First Wave

OBJECTIVES

The COVID-19 pandemic required a population lockdown during the first wave in March 2020. Evidence has shown a circular relationship between perceived threat and the risk of developing negative mood, which might impact the affect balance of older adults. We aimed to investigate the positive and negative feelings expressed by young-old (60-70 years) and old-old (over 71 years) Spanish adults during the lockdown of the COVID-19 first wave, and the social and psychological variables associated.

METHODS

Cross-sectional study conducted in 528 participants using a questionnaire composed of sociodemographic data and validated scales for resilience (Brief Resilient Coping Scale) and emotions (Scale of Positive and Negative Experience).

RESULTS

We found a positive balance between positive and negative feelings with no differences between both groups. Regression analysis showed that social network and resilience, but not age, are significant predictors of both greater positive feelings and lower negative feelings.

CONCLUSIONS

Our results evidence the relevance of promoting targeted support psychological and social measures that effectively help older adults to cope with such a difficult scenario as the current pandemic.

CLINICAL IMPLICATIONS

Health-care providers must develop targeted care strategies aimed at providing emotional support for older adults from a holistic perspective.

Care tasks and impact of caring in primary family caregivers: A cross-sectional study from a nursing perspective

BACKGROUND

Family caregivers of persons with dementia often experience a negative impact on their health. More studies based on nursing theories are needed to improve the provision of care.

AIMS

To describe the care provided by family caregivers of persons with dementia and the impact on their health, as well as to analyse how personal variables of caregivers are related to care tasks and their health impact.

METHODS

Multi-centric cross-sectional prospective study conducted on a sample of 423 primary family caregivers of persons with dementia from Spain. Data were collected through ICUB97-R questionnaire (January-April 2019), based on the fourteen needs of Virginia Henderson's Nursing Model. Data was analysed through one-way analysis of variance and Student's t-test.

RESULTS

The caregiver profile was a middle-aged married woman without higher education living with the cared person, predominantly her mother. The most frequently provided care corresponded to "nutrition" and "movement" needs. Lack of free time, modifications on leisure activities, reduced sleep or rest and disruption of family life emerged as the greatest repercussions on the caregiver's health. The age of the caregiver and time caring showed differences on impact of care and care tasks, respectively.

CONCLUSION

The identification of the types of care provided, the health impact of caring and the variables affecting the family caregiver's vulnerability is essential to develop effective individualised nursing care plans, including health education interventions to improve the quality of life of both caregivers and persons cared for.

Gender impact of caring on the health of caregivers of persons with dementia

BACKGROUND

Dementia is a brain syndrome that affects a growing number of persons worldwide and generates a strong and progressive demand for care from a family caregiver, usually females.

OBJECTIVE

We aimed to describe the care provided by family caregivers of persons with dementia as well as the impact on their health and its interrelation with gender.

PATIENT INVOLVEMENT

This study was carried out in collaboration with the 13 associations of family caregivers of persons with dementia that are part of a Regional Federation. This partnership worked towards bettering patient care and proposing improvements to the public health system.

METHODS

A multi-institutional cross-sectional study. A total of 462 primary family caregivers of persons with dementia from north-west Spain were included. Data were collected between January and April 2019 with an anonymous self-administered validated questionnaire (ICUB-97) based on Virginia Henderson's nursing care model.

RESULTS

The most affected needs in family caregivers are those related to "recreational activities", "communication" and "rest and sleep". Statistically significant differences between male and female participants' pattern of care and health-related impacts were found, especially in issues related to work and family reconciliation.

DISCUSSION

Care plans should be developed taking gender perspective into account. From a nurse model point of view, more research is necessary to reduce health disparities. This study provides an assessment of gender differences in care and the impact on caregivers' health.

PRACTICAL VALUE

Regarding the specific health conditions of female caregivers and from a holistic point of view, these findings could provide novel and interesting data that might help to implement gender perspective in nursing care plans, generally invisible in routine clinical practice.

Personality Variables as Predictors of Health Services Consumption

Expenditure on healthcare and services can be a serious problem for public health. Personality variables should be included as indicators to be considered when studying the consumption of health resources and their planning. This study aims to identify the psychological and psychosocial variables that identify people who can be considered high consumers of health resources versus those who barely consume such resources. The sample was made up of a total of 1124 subjects; one half were men, and one half were women, all of legal age and residents in Spain. A battery of tests was created that included a questionnaire of sociodemographic variables and of healthcare consumption, as well as several psychological variables (Zimbardo Time Paradox Inventory, Multidimensional Locus of Control Scale, Psychological Reactance Scale, Coping Responses Inventory, self-efficacy scale applied to health, and the Symptom Checklist-90-R). The following variables of the model were significant predictors (p ≤ 0.05): a negative past, a fatalistic present, psychological cognitive reactance, behavioral coping, health self-efficacy, and the level of somatization. Data from the statistical analyses show how to create a psychological profile of people who are high consumers of healthcare resources that will allow for the creation of intervention programs in this regard.

[The botellón phenomenon. Descriptive analysis and possible implications from a sample of galician teenagers.]

OBJECTIVE

Botellón has established itself as a recreational ritual of great importance in the leisure of young people and it has contributed to the expansion of a worrying pattern of alcohol and other substances consumption. However, there are few papers that take an integrated approach to this issue. The aim of this work was to have new data to characterize this practice, while providing evidence of its consequences and identifying relevant prognostic factors for prevention.

METHODS

A cross-sectional study was carried out with a sample of 4,867 Galician adolescents between 12 and 18 years of age (Mean=14.68; SD=1.67). Data were collected in schools through an ad hoc questionnaire and they were analyzed through of a bivariate tabulation, with the application of the opportune contrasts according to the nature of the variables.

RESULTS

27.3% of the teenagers in the sample went to botellón during the last year. 96.6% admitted to drinking alcohol when they went to a botellón, 53.4% alcohol and tobacco and 30.2% three or more substances. This practice was associated with significantly higher rates of Intensive Alcohol Consumption (28% vs. 0.9%), as well as of consumption of risk of alcohol, cannabis and drugs in general. The modulating role of variables such as risk perception and beliefs and expectations associated with consumption, money available or time of arrival at home was also found.

CONCLUSIONS

At least 1 in 4 teenagers continue to go to botellones. This practice associated with risky consumption. The evidence found reinforces the multidimensional nature of the problem and suggests reorienting prevention policies.

The Impact of Self-Efficacy and Subjective Cognitive Complaints on Health Care Use Among Middle-Aged Adults

Self-efficacy (SE) has been shown to be a remarkable cognitive factor affecting health. Subjective perception of memory and other cognitive failures (i.e., subjective cognitive complaints [SCC]) have been associated with self-perception. The authors studied whether SE is a relevant subjective variable in predicting SCC in middle-aged adults living in the community (N = 438) and explored the role of SE and SCC in predicting health care use. SE, age, and cognitive performance predicted SCC. SE, age group, cognitive status, and SCC were predictors of health care use in univariate logistic regression analysis, although only SE, age group, and cognitive status remained significant in the multivariate analysis. The influence of SCC in health care use seems to be mediated by subjective estimations, such as those measured by SE. The authors suggest that well-implemented health education interventions might contribute to an increase in SE in middle-aged adults with a subsequent decrease in SCC, which would have a relevant effect in reducing the burden of care. [Research in Gerontological Nursing, 13(5), 228-232.].

Types of love as a function of satisfaction and age

Research studies on love have focused on the study of typologies, among which Sternberg's triangular theory of love and the typology of Hendrick and Hendrick deriving from that of Sternberg have been the most common and empirically verified. Love types have been linked to all types of sociodemographic and psychological variables. However, these studies possess shortcomings: When the data are analyzed according to age, only a few ranges are studied; with respect to other variables such as satisfaction, typically only two levels are studied, and no continuous study is conducted. This study attempts to overcome these limitations. It analyzes types of love according to the two systems noted earlier and based on two variables: age and satisfaction. For satisfaction, the Satisfaction With Life Scale (SWLS) by Diener et al. was used, and 439 subjects aged 15 to 89 years participated in the study. The results show that both of the variables-age and satisfaction-explain that love types occur in varying degrees; however, satisfaction is more predictive than is age. Possibilities for future research are discussed.

Psychological, Social and Health-Related Challenges in Spanish Older Adults During the Lockdown of the COVID-19 First Wave

Background: The global pandemic of COVID-19 has required a population lockdown. Spain has one of the oldest/most aging populations in the world and was one of the most affected countries. We aim to describe the psychological and social implications as well as health-related behaviors as a result of the lockdown in community-dwelling older adults. Materials and Methods: Observational cross-sectional study. A total of 528 participants of over 60 years of age were recruited using snowball sampling technique during the lockdown of the COVID-19 first wave using an anonymous self-administered questionnaire composed of descriptive questions and validated scales for resilience (Brief Resilient Coping Scale) and emotions (Scale of Positive And Negative Experience). Results: Most participants (76.9%) live with other people and have an open space at home (64%). Only 33.7% continued doing activities to promote healthy aging, 65.7% did less physical activity and 25.6% increased their intellectual activity. Most of them (83%) used electronic communication with family and friends to a greater extent, and left the house to run basic errands. Greater scores on resilience showed significant negative correlations with age and negative feelings, and positive correlations with the size of the social network and positive feelings. Lacking an open space at home was associated with more negative feelings. Discussion: Older people are a vulnerable group severely affected by this pandemic crisis at multiple levels, requiring specific interventions to minimize the effects of changes in lifestyle that may be harmful. Detecting needs is essential to improve care and support from community health and social services, both nowadays and in future similar situations.

Institutional Violence Against Users of the Family Law Courts and the Legal Harassment Scale

The term harassment is often used to refer two contexts, the workplace and school, but not the legal system itself. Long drawn-out litigation in the Family Law Courts often produces a surreptitious phenomenon of violence toward one of the litigating parties, who become victims of the legal system itself. The aim of this study was to determine whether legal harassment could be detected and measured in the Spanish Justice System using an innovative Legal Harassment Scale (LHS). This hypothesis was substantiated by the data obtained using a new 32-item psychometric instrument with a global index: the LHS, consisting of four factors: Direct Aggression, Procedural Harassment, Personal Contempt, and Manipulation of Reality. The estimated reliability and validity of the LHS was satisfactory, both in terms of the global score, and for each of the four factors distributed along the normal curve. The results of this study are discussed in terms of the limitations of the study and in relation to future lines of research aimed at ensuring that the legal system respects and safeguards the rights of the parties involved in litigation, and that no party falls victim to legal harassment.

Cognitive frailty: A conceptual systematic review and an operational proposal for future research

OBJECTIVE

To analyze the definition of "cognitive frailty" and to study the conceptual and operational definitions used and their implications for empirical research. The relationships between this concept and cognitive reserve, the role of neuropathology and brain reserve, motor signs of aging and the reversibility of cognitive frailty are also discussed.

STUDY DESIGN

Systematic review of empirical studies identified from Medline Advanced 1966, CINAHL, Web of Science, PsycINFO, and Scopus until August 2017.

MAIN - OUTCOME MEASURES

Effect sizes. The quality of the articles was assessed by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Statement. Three independent reviewers participated in the study selection and data extraction.

RESULTS

Nineteen studies involving 31,707 participants met the inclusion criteria. Significant associations were reported between cognitive frailty and physical frailty or gait speed. Screening instruments were usually used to determine objective cognitive decline rather than extensive neuropsychological assessments. Educational level was the only indicator of cognitive reserve that was systematically included in the evaluation of cognitive frailty. Motor decline and gait variables were not systematically included in protocols for the assessment of cognitive frailty.

CONCLUSIONS

A strong operational definition would benefit both the development of treatments to counter cognitive frailty and the assessment of treatment effectiveness. Nevertheless, since there is clear agreement regarding the importance of interventions for and the prevention of cognitive frailty, randomized controlled trials investigating the efficacy of preventive interventions are necessary.

The use of physical restraints in long-term care in Spain: a multi-center cross-sectional study

BACKGROUND

Physical restraint is a procedure used frequently in long-term care. It is a controversial practice because its use is associated with numerous complications and also affects freedom and individual autonomy. The objective of this study was to examine the use of physical restraint of long-term care residents with the ability to move voluntarily.

METHODS

We conducted a cross-sectional observational and correlational multi-center study. Nine centers agreed to participate. Of the 1,200 people present at the time of data collection, those without voluntary movement or in the facility for less than a month were excluded. Thus, the final sample was 920 residents. Data on the use of restraints was collected by direct observation. Information about the age, gender, length of stay, falls, mobility, cognition and functional status of residents was gathered by reviewing clinical records and interviewing nursing staff. A descriptive analysis of the data obtained was conducted. The generalized linear model was used, considering only the principal effects of each variable and using the logit link function. The model has been adjusted for clusters and for other possibly confounding factors. For all analyses, a confidence interval (CI) of 95% was estimated.

RESULTS

The prevalence of residents with at least one physical restraint was 84.9% (95% CI: 81.7-88.1), with variability between centers of 70.3 to 96.6% (p-value Kruskal Wallis test <0.001). Full-enclosure side rails were most often used (84.5; 95% CI: 81.1-87.9), but other types of restraints were also used frequently. Multivariate analysis showed that the degree of functional impairment increased the probability of the use of restraint. A significant association was also found between restraint use and the impaired cognitive status of residents.

CONCLUSIONS

The prevalence was higher than in studies from other countries. The results emphasize the need to improve the training of nursing staff in the care of residents with impairments in functional and cognitive status. The use of alternative devices and nurse consultants need to be evaluated, and the introduction of specific laws considered.

Self-efficacy and Health: The SEH Scale

OBJECTIVES

Our objective was to design an instrument to measure coping self-efficacy as manifested by patients experiencing health problems.

METHODS

A total of 2784 individuals were interviewed while attending primary healthcare centers in the Autonomous Community of Galicia in Northwest Spain. Of these persons, 54% were women and 46% were men, with a minimum age of 18 years, and a mean age of 37.4 years. A questionnaire was administered comprised of sociodemographic variables, items related to the use of healthcare resources, and a coping self-efficacy scale of health problems (SEH), based on the self-efficacy test by Baessler and Schwarzer. Statistical analysis determined reliability, and whether the SEH scale was efficacious in detecting changes in the use of specific health resources. A parametric ANOVA was performed on 4 groups based on the quartiles of self-efficacy in health, as measured by the SEH scale.

RESULTS

The reliability and validity of the 10-item coping self-efficacy scale of health problems (SEH) was confirmed.

CONCLUSIONS

Its compliance with relevant psychometric requirements means the SHE scale may have more general utility.

Perception of spanish nursing staff on the use of physical restraints

PURPOSE

To examine the perception of registered nurses and nursing assistants regarding the use of physical restraints with residents of nursing homes located in four of the regions of Spain; and to evaluate the relationship of these perceptions to the staff respondents' level of training.

DESIGN

Cross-sectional multicenter and correlational study. The research was conducted in 2013 in 19 Spanish nursing homes with 2,940 residential beds. A total of 785 nurses (170 registered nurses and 615 nursing assistants) participated in the study.

METHODS

The Perception of Restraint Use Questionnaire (PRUQ), consisting of 17 of the most cited reasons for using these devices, was used, as was a questionnaire capturing the sociodemographic characteristics and educational or experience level of staff respondents.

FINDINGS

Nurses reported the most important uses for restraints as prevention of falls and avoidance of medical device interference. As indicated by an average PRUQ score of 3.47, staff respondents supported restraint use, especially nursing assistants (3.59) as compared to registered nurses (3.00). With regard to training: 83.7% had participated in little, if any, training and only 29.2% had read three or more documents related to restraint use; 66.6% believed that their training was inadequate. No correlation was found between the results of the PRUQ and the respondents´ sociodemographic characteristics or participation in training activities. No differences were found among nurses by region.

CONCLUSIONS

In contrast to papers published in other countries, nurses in this study still consider it necessary to apply restraints in everyday practice. The education of nursing staff regarding restraint and knowledge of alternatives is needed; they should at least be aware of international standards of care regarding physical restraint use.

CLINICAL RELEVANCE

Most of the staff perceived their training related to the use of these devices as insufficient. Nursing assistants considered the use of restraints more important than did the registered nurses.

Personal determinants of burnout in nursing staff at geriatric centers

There is a high prevalence of stress in the workplace among nursing personnel at elderly care-centers. The general impression is that these high stress levels are related to conflict within the workplace. The purpose of this study is to evaluate whether personal factors (in particular personality and values), are related to burnout. For this reason we asked a sample of 42 nursing personnel from care-centers for the elderly to complete a self-administered questionnaire on conflict at work, stress at work, personality and motivational values for nursing professionals in elderly residences. Personality variables and motivational values were found to be significantly related to the appearance of stress in the workplace.

Helping the family carers of Alzheimer’s patients: from theory…to practice. A preliminary study

Alzheimer's disease (AD) represents one of the most important health issues in the western world. The ongoing care that the AD patient requires typically causes high stress levels, fatigue, irritation and depression in the caregiver, as well as socio-economical problems. The current study aimed to introduce a support program for carers of AD patients, in order to improve their quality of life. A Questionnaire for Carers and an Anxiety State Feature Questionnaire (STAI) was used to assess the carers. Results showed an overall improvement in the carers' health. Their subjective wellbeing increased, and though their situation had not changed, they nevertheless described feeling less trapped. It can be concluded that possibly the mere fact that the carers feel that they have help available is enough to endorse the value of the program.