Los hogares y residencias protegidas son elementos centrales de la red asistencial que atiende a personas con un diagnóstico de trastorno mental severo, dentro del modelo de salud mental comunitaria. ...Este modelo tiene como uno de sus propósitos centrales estimular la autonomía y participación social de los usuarios. Se evaluó la restrictividad presente en estos dispositivos y factores asociados a su predicción. Se evaluaron 21 servicios residenciales mediante la escala de prácticas restrictivas que se aplicó a un cuidador por lugar. Se observó que estos dispositivos poseen un nivel de restrictividad que limita la capacidad para tomar decisiones de los residentes en aspectos de su vida. Esta situación dificulta el empoderamiento y la participación de las personas en la comunidad.
Interventions to reduce the stigma of health care personnel toward people with mental disorders have been generally evaluated fundamentally by improving attitudes and reducing the desire for a social ...distance toward this population. However, decreasing stigma should be accompanied by an increase in good treatment behaviors toward those affected. Humanization of care, which is understood as a friendly, respectful, and supportive relationship, could be an excellent way to evaluate the effectiveness of antistigma interventions. This requires reliable and valid instruments. This study aimed to examine the psychometric properties of the humanized care behavior scale used in health care personnel. The study was quantitative and cross-sectional. The participants were a nonrandom sample of 217 health providers from 12 family health centers in Gran Concepción, Chile. An exploratory factorial analysis was applied to study the factorial structure, and Cronbach's alpha and McDonald's total omega coefficients were used to evaluate the internal consistency. The concurrent validity was assessed through a correlational analysis with three other scales. Regarding the results, the final scale comprised 16 items in two factors. There was an acceptable correlation between the two dimensions. The reliability indices for the total scale were high. Correlations between the total scale and its factors with the other scales used were in the expected direction. Consequently, the instrument developed is valid and reliable. It can be used to evaluate antistigma interventions and improve health personnel's humanization of care toward consultants with mental disorders.
Public Significance Statement
This study evaluated a scale for assessing humanized care provided by health care personnel to individuals with mental disorders. Humanized care is defined as a friendly, respectful, and supportive relationship and is a crucial factor in reducing stigma associated with psychiatric diagnoses. The scale exhibited good psychometric properties, indicating its usefulness in evaluating nonstigmatized and humanized behavior toward people with mental disorders.
Simple and brief questionnaires with adequate psychometric properties are useful for the early detection of depressive disorders.
To analyze the psychometric behavior of the Patient Health ...Questionnaire (PHQ-9) in Chile.
Data were collected from 1,738 adult patients, consulting in primary health care centers. The values obtained in the PHQ-9 were compared with those of the Composite International Diagnostic Interview (CIDI).
The mean score of PHQ-9 was 4.85 ± 5.57. Internal consistency indices were high. McDonald's ω coefficient of was 0.90 and Cronbach alpha 0.89. A confirmatory factor analysis showed a good fit of the one-dimensional model. Using a cutoff score of seven determined with the receiver operating characteristic (ROC) curve, the sensitivity and specificity of the instrument were 0.8 and 0.7, when compared with CIDI diagnoses.
PHQ-9 is a useful instrument for the screening of depressive disorders in primary health care centers in Chile.
Objective: To increase the knowledge of rumination and its associations with stressful events, we explored the relationships between 4 types of rumination (brooding, reflection, intrusive, and ...deliberate rumination) in a sample of 750 adult participants who experienced a highly stressful event. We also explored the predictive value of the different types of rumination on posttraumatic stress symptoms and posttraumatic growth 6 months after the highly stressful event occurred. Method: Participants completed the Ruminative Response Scale and the Event-Related Rumination Inventory. Brooding and reflection rumination were obtained from the Ruminative Response Scale, whereas deliberate and intrusive rumination were obtained from the Event-Related Rumination Inventory. Confirmatory factorial analyses were conducted using the 4 types of rumination to test 3 different models: (a) 4-factor model (brooding, reflection, intrusive, and deliberate rumination), (b) 2-factor model: adaptive rumination (reflection and deliberate) and maladaptive rumination (brooding and intrusive), and (c) 2-factor model: depressive rumination (brooding and reflection) and posttraumatic rumination (intrusive and deliberate). Results: It was observed that the 4-factor model showed the best fit to the data. Moreover, 6 months later it was observed that the most significant predictor of posttraumatic symptoms was intrusive rumination, whereas deliberate rumination was the most significant predictor of posttraumatic growth. Conclusions: Results indicate that the 4 types of rumination are differentiated constructs. Ruminative thoughts experienced after a stressful event predicted posttraumatic consequences 6 months later. Implications of these findings are discussed.
Subjective Well-Being and Parenthood in Chile Novoa, Consuelo; Bustos, Claudio; Bühring, Vasily ...
International journal of environmental research and public health,
07/2021, Letnik:
18, Številka:
14
Journal Article
Recenzirano
Odprti dostop
Being a parent plays an important role in people’s life trajectory and identity. Though the general cultural perception is that having children is a source of subjective well-being, there is evidence ...that, at least in some societies, the subjective well-being of those who are parents is worse, in some aspects, than that of those who are not. This gap has been the object of interest and controversy. The aim of this study was to compare Chilean adults with and without children in a broad set of well-being indicators, controlling for other sociodemographic variables. A public national probabilistic database was used. The results show that, in terms of positive and negative affect, those who are not parents achieve greater well-being than those who have children. Other results also pointed in that direction. The implications of the social context and gender, which are aspects that pose a burden for the exercise of parenthood in Chile, are discussed.
Objective To identify elements that either facilitate or hinder implementation of Chile's intercultural health policy. Methods A descriptive study was conducted with the participation of health ...services users from the Mapuche ethnic group, biomedical health professionals, intercultural facilitators, and key informants in two health facilities serving towns with a high density of Mapuche population. The information was obtained through semi-structured interviews that were analyzed thematically. Results Factors identified as facilitating the implementation of this policy include laws and regulations pertaining to the rights of indigenous peoples, the empowerment of users around their rights, the formation of implementation teams, the presence of professionals of Mapuche origin in health facilities, and the existence of processes for systematization of the work carried out. The asymmetric relationship between the Mapuche people and the state, and between the Mapuche health system and the biomedical model, constitutes a fundamental barrier. Other obstacles include the lack of theoretical and practical clarity around the concept of intercultural health and a lack of resources. Conclusions Despite the facilitators identified and the achievements to date, meaningful progress in implementation of an intercultural health policy is limited by barriers that are hard to change. These include the usual forms of government planning and the hegemony of the biomedical model.
This study analyzed a predictive model of posttraumatic growth (PTG) in a cohort of 244 workers affected by an occupational accident. A longitudinal design with three points in time (i.e., 1, 6, and ...12 months after the accident) was used. PTG, posttraumatic stress symptoms (PTSS), subjective severity of the event, deliberate rumination, and seeking social support were evaluated. In addition, time since the accident, age, and gender were included as predictors in our model. Deliberate rumination and seeking social support significantly predicted PTG trajectory in a multilevel model. Practical conclusions from the results suggest that work accident victims should be encouraged to seek social support and to positively reframe their experience.
Background:
Parenting training is a proven strategy for the promotion of positive parenting practices and for the prevention and treatment of behavior problems in children. The processes that explain ...this efficacy are less clear. The aim of this study was to assess the mediating role of parenting practice modification, encouraged through the implementation of a universal parenting training program, for the decrease of behavior problems in 3- to 6-year-old children.
Method:
A cluster randomized trial was carried out in 19 educational centers in low and middle socioeconomic areas. A total of 178 families received the program and 154 of them were the control group. The following parenting practices were assessed: positive reinforcement, involvement, inconsistency, unsuitable treatment behaviors and physical punishment, as well as hostility and humiliation behaviors. Parent–child interaction was also assessed using an observational instrument. A multiple mediation analysis was carried out, identifying the indirect effects.
Results:
Reduction of harsh discipline and physical punishment, and parental inconsistency mediated the effects observed in the reduction of child behavior problems during the program.
Conclusion:
Within Chilean families, harsh discipline, physical punishment, and parental inconsistency are important aspects to be considered in the implementation of universal parenting training programs.
In this article, the evaluation of a structural model that seeks to identify predictors and mediators of posttraumatic growth (PTG) of people affected by a natural disaster is presented.
The sample ...was composed of 349 adult men and women who experienced the earthquake and tsunami on February 27, 2010 in Chile. A modeling with structural equations was used, contrasting two predictive models of PTG. The latent variables assessed were subjective severity, social sharing of emotion, intrusive rumination, deliberate rumination, problem-focused coping and posttraumatic growth.
The best fit was obtained with the model that shows a direct influence of the subjective severity, problem-focused coping, and deliberate rumination in the presence of PTG. Problem-focused coping mediated the relation between subjective severity and social sharing with PTG. In turn, deliberate rumination mediated the relation of problem-focused coping and intrusive rumination with PTG.
The results show the relevant role of cognitive processes such as deliberate rumination and behavioral processes such as problem-focused coping in the presence of PTG.
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