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      Factores asociados al desarrollo de estrés, ansiedad y depresión en trabajadores sanitarios en el contexto de la pandemia por COVID-19 en Perú Translated title: Factors associated with the development of stress, anxiety and depression in the context of COVID-19 pandemic in Peruvian healthcare facilities

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          Abstract

          Resumen Objetivo: Describir las características sociodemográficas y determinar los factores asociados a manifestaciones psicológicas de depresión, ansiedad y estrés en trabajadores sanitarios en el contexto de la pandemia por COVID-19 en los establecimientos de salud del Perú durante mayo de 2020. Métodos: Se realizó un estudio transversal en trabajadores sanitarios de establecimientos hospitalarios del Perú. Se elaboró un cuestionario estructurado que incluía las características sociodemográficas, la profesión, área y lugar de trabajo, y cuestionarios validados para trastorno de ansiedad generalizada (GAD-7), Salud del paciente (PHQ-9) y la Escala de impacto del estresor revisada (IES-R). Para el análisis se utilizó modelos lineales generalizados de Poisson, función de enlace logarítmico y varianzas robustas. Se calculó el rango intercuartílico (RIC) y la razón de prevalencia ajustada (RPa) y su intervalo de confianza del 95% (IC95%). Resultados: De un total de 258 encuestados, 254 (98%) completaron al cuestionario, siendo el 61,8% mujeres y el área de trabajo más común emergencia u hospitalización (62,2%). La puntuación mediana del PHQ-9 fue 4 (RIC:2-7), del GAD-7 fue 6 (RIC:4-8) y para el IES-R fue 16 (RIC:8-24). El análisis multivariado mostró que ser médico se asocia con una menor prevalencia de ansiedad (RPa: 0,77; IC 95%: 0,62-0,94), mientras que vivir solo se asoció con una mayor prevalencia de depresión (RPa: 1,46; IC 95%: 1,11-1,92). Conclusión: El personal sanitario manifestó alteraciones psicológicas, asociado principalmente al personal no médico y vivir solo.

          Translated abstract

          Abstract Objective: To describe the sociodemographic characteristics and determine the factors associated with psychological manifestations of depression, anxiety, and stress in healthcare workers in the context of COVID-19 pandemic in health facilities in Perú during the month of May 2020. Methods: An analytical cross-sectional study was conducted out in healthcare workers of hospital establishments in Perú. To evaluate the outcome of interest, we administered a structured questionnaire that asked about type of healthcare personnel; sociodemographic characteristics; Generalized Anxiety Disorder scale (GAD-7); Patient Health Questionnaire scale (PHQ-9); and the Revised Stressor Impact scale (IES-R). We used generalized linear Poisson models, with a logarithmic link function and robust variance. Results: Out of 258 respondents, 254 completed the survey; 61.8% were women; the most common work area was emergency department or hospitalization (inpatient) services (62.2%). The median PHQ-9 score was 4 points (IQR: 2-7); for the GAD-7, it was 6 points (IQR: 4-8), and for the IES-R, 16 points (IQR: 8-24). The multivariate analysis showed that being a physician was associated with less anxiety (PR: 0.77; 95% CI: 0.62-0.94), whereas living alone was associated with a greater risk of depression (PR: 1.46; 95% CI: 1.11-1.92). Conclusions: Healthcare personnel are at risk of manifesting psychological alterations, mainly associated with the female gender, non-medical personnel and living alone.

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          A brief measure for assessing generalized anxiety disorder: the GAD-7.

          Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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            Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019

            Key Points Question What factors are associated with mental health outcomes among health care workers in China who are treating patients with coronavirus disease 2019 (COVID-19)? Findings In this cross-sectional study of 1257 health care workers in 34 hospitals equipped with fever clinics or wards for patients with COVID-19 in multiple regions of China, a considerable proportion of health care workers reported experiencing symptoms of depression, anxiety, insomnia, and distress, especially women, nurses, those in Wuhan, and front-line health care workers directly engaged in diagnosing, treating, or providing nursing care to patients with suspected or confirmed COVID-19. Meaning These findings suggest that, among Chinese health care workers exposed to COVID-19, women, nurses, those in Wuhan, and front-line health care workers have a high risk of developing unfavorable mental health outcomes and may need psychological support or interventions.
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              Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population.

              The 7-item Generalized Anxiety Disorder Scale (GAD-7) is a practical self-report anxiety questionnaire that proved valid in primary care. However, the GAD-7 was not yet validated in the general population and thus far, normative data are not available. To investigate reliability, construct validity, and factorial validity of the GAD-7 in the general population and to generate normative data. Nationally representative face-to-face household survey conducted in Germany between May 5 and June 8, 2006. Five thousand thirty subjects (53.6% female) with a mean age (SD) of 48.4 (18.0) years. The survey questionnaire included the GAD-7, the 2-item depression module from the Patient Health Questionnaire (PHQ-2), the Rosenberg Self-Esteem Scale, and demographic characteristics. Confirmatory factor analyses substantiated the 1-dimensional structure of the GAD-7 and its factorial invariance for gender and age. Internal consistency was identical across all subgroups (alpha = 0.89). Intercorrelations with the PHQ-2 and the Rosenberg Self-Esteem Scale were r = 0.64 (P < 0.001) and r = -0.43 (P < 0.001), respectively. As expected, women had significantly higher mean (SD) GAD-7 anxiety scores compared with men [3.2 (3.5) vs. 2.7 (3.2); P < 0.001]. Normative data for the GAD-7 were generated for both genders and different age levels. Approximately 5% of subjects had GAD-7 scores of 10 or greater, and 1% had GAD-7 scores of 15 or greater. Evidence supports reliability and validity of the GAD-7 as a measure of anxiety in the general population. The normative data provided in this study can be used to compare a subject's GAD-7 score with those determined from a general population reference group.
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                Author and article information

                Journal
                aprl
                Archivos de Prevención de Riesgos Laborales
                Arch Prev Riesgos Labor
                Societat Catalana de Salut Laboral y Asociación de Medicina del Trabajo de la Comunidad Valenciana (Barcelona, Barcelona, Spain )
                1578-2549
                September 2022
                : 25
                : 3
                : 271-284
                Affiliations
                [1] Lima Lima orgnameUniversidad Nacional Mayor de San Marcos Peru
                [3] Lima Lima orgnameUniversidad Científica del Sur Peru
                [2] Lima Lima orgnameUniversidad Peruana de Ciencias Aplicadas Peru
                Article
                S1578-25492022000300271 S1578-2549(22)02500300271
                10.12961/aprl.2022.25.03.04
                99fb143e-d633-4d25-91c4-5af67a151df0

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 07 April 2022
                : 29 October 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 30, Pages: 14
                Product

                SciELO Spain

                Categories
                Originales

                COVID-19,healthcare personnel,mental health,anxiety,depression,stress,personal de salud,salud mental,ansiedad,depresión,estrés

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