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Ultrasonography is a non-invasive and safe method for assessing muscle morphology. Among its parameters, echo intensity (EI), derived from grayscale image analysis, has emerged as a promising indicator of muscle quality and intramuscular fat infiltration. This study aims to validate EI as a marker for evaluating muscle quality in a population of Czech children, through integration with gold-standard assessments of muscle strength and body composition. The primary aim of this study is to assess the reliability and construct validity of quadriceps muscle EI using ultrasound as a proxy measure of morphological muscle quality in children aged 10–14 years.
Children aged 10–14 years will undergo ultrasound assessment of the quadriceps femoris (QF). EI will be derived from longitudinal scans of each QF head and the cross-sectional area (CSAQF) from panoramic mid-thigh images. Muscle function will be assessed as maximal voluntary contraction (MVC) of isometric knee extension with muscle quality expressed as MVC/CSAQF. A 30 s sit-to-stand test (30STS) will be used as an additional functional measure. EI reliability (intra-rater, inter-rater and test–retest) will be evaluated with intraclass correlation coefficients (ICC), Bland–Altman plots and complementary indices. Exploratory known-groups validity will be tested by comparing EI between weight-status groups. Control variables include dual-energy X-ray absorptiometry (DXA)-derived body composition, skeletal age (as determined by DXA hand scans) and physical activity (assessed using 7-day accelerometry).
This study will include 200 children (100 girls and 100 boys) aged 10–14 years using an a priori power analysis based on the primary objective of assessing construct validity through multiple linear regression, assuming an alpha level of 0.05 and 80% power. Participants will be recruited from paediatric outpatients of the Paediatric Obesity Clinic and individuals reached through a recruitment campaign. Inclusion criteria require general good health, while exclusion criteria include a history or symptoms of cardiovascular, pulmonary, metabolic or neurological disease, as well as the use of over-the-counter or prescribed medications. Informed consent and assent will be obtained from all participants.
Reliability of ultrasound-derived EI will be assessed for intra-rater, inter-rater and test–retest agreement using ICC coefficients, Bland–Altman plots and complementary indices such as SE of measurement, coefficient of variation and minimal detectable change at 95% CI, following Consensus-based Standards for the selection of health Measurement Instruments guidelines. Construct validity will be examined by modelling associations between EI and functional muscle quality (MVC/CSAQF), with 30STS as an additional functional measure. Known-groups validity will be tested by comparing EI across weight groups, using generalised linear regression models adjusted for skeletal age, body composition and physical activity. All validity analyses will be conducted separately for girls and boys. Ultrasound-derived EI of the QF is expected to show high reliability (ICC≥0.80) and acceptable test–retest reproducibility. Construct validity should be supported by moderate associations with functional muscle quality (MVC/CSAQF), while known-groups validity is expected to reveal higher EI values in children with obesity and/or insufficient physical activity.
The study will be conducted in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of the Faculty of Physical Education and Sport, Charles University (EK 101/2024). Written parental consent and verbal assent from children will be obtained, with all data handled confidentially and anonymised. Results will be disseminated transparently to participants and their families in line with ethical principles of respect, beneficence and justice.
To describe the implementation determinants for care coordination interventions in a hospital context.
Systematic review.
This review was guided by the Consolidated Framework of Implementation Research (CFIR), assessed for quality using the Mixed Methods Appraisal Tool and reported with the PRISMA guidelines.
CINHAL Complete, EMBASE, MEDLINE Complete, PsychINFO (between January 1, 2013, and December 31, 2022, and updated May 09, 2024) and a manual reference list search of all included studies.
The search returned 5614 articles after duplicates were removed. After title and abstract screening, 264 articles underwent full-text review. Sixteen studies (15 care coordination models) met the inclusion criteria. The CFIR inner setting domain and the implementation process domain were the most prominent domains and ‘Partnerships & Connections’, ‘Work Infrastructure’, ‘Capability’ and ‘Reflecting and Evaluating’ subdomains emerged as important determinants across the included studies.
Inconsistent findings relating to care coordination outcomes are likely to be substantially influenced by the complexity and heterogeneity of the interventions and variations in implementation and contextual factors. Intra- and inter-organisational relationships were important to connect previously disconnected parts of the health system and were facilitated by experienced care coordinators. Continual improvement was also important to increase fit with contextual factors. More high-quality studies are needed to identify commonalities and provide generalisable principles and characteristics associated with high-performance implementation.
Review findings will provide practitioners, policymakers, and researchers with a comprehensive synthesis of evidence underpinning implementation of effective community care coordination from hospital settings.
These review findings will inform the effective implementation of care coordination interventions in a hospital context for patients with complex multimorbidity.
Preferred Reporting Items for Systematic reviews and Meta-Analysis.
PROSPERO Registration: CRD42022376642.
No patient or public Contribution.
by Ramesh Malashi, Sunita Sharma, Srijana Adhikari, Chitra Raj Sharma, Arun Kumar Joshi, Buna Bhandari
IntroductionHypertension is a significant risk factor for cardiovascular diseases (CVDs), which remains the leading causes of morbidity and mortality globally, with a disproportionate impact on low and middle income countries. While hypertension is prevalent across various populations, government employees are particularly susceptible due to high stress levels, sedentary lifestyles, and work-related pressures. Therefore, this study was undertaken to assess the prevalence of hypertension and its associated risk factors among government employees in the Doti district of Nepal.
MethodsA cross-sectional study was carried out among 195 government employees in Dipayal Silgadhi Municipality of Doti district of Sudurpashchim province of Nepal. The data was collected through face-to-face interviews using Simple Random Sampling (SRS) technique and analysed using SPSS v25. The structured questionnaire adopted from the WHO STEPS survey tool was used for data collection. Bivariate and multivariate logistic regression model was used to assess the factors associated with hypertension.
ResultsThe prevalence of hypertension among government employee was 36.4%% ± 5.6%. Participants with age group 30–40 years [Adjusted Odd’s Ratio (AOR) 14.4, 95% Confidence Interval (CI) (1.6, 127.7)], 40–50 years [AOR 13.7, 95% CI (1.04, 180.3)] and work experience (20–30 years) [AOR 6.67, 95% CI(1.23, 35.9), and drinking alcohol [AOR 0.35, 95% CI (0.17, 0.72)] were found to be statistically significant with hypertension.
ConclusionThe study revealed the high prevalence of hypertension among government employees; significantly associated with risk factors like age group 30–50 years, work experience and alcohol consumption, indicating an alarming public health concern. These results highlight the pressing need for focused interventions to reduce the risk of hypertension and its related problems among government employees, such as lifestyle changes, workplace health programs, and routine health screenings.
Polypharmacy, defined as the concurrent use of multiple medications, is a growing concern among the elderly, especially in low-income and middle-income countries such as Iran. This study aims to explore the prevalence and patterns of polypharmacy among the elderly in Iran, using health insurance claims data to identify common drug classes and coprescribed medications, with a focus on informing policy decisions and improving medication management.
Retrospective population-based observational study.
Nationwide data from the Iran Health Insurance Organization (IHIO) across 24 provinces.
1 876 527 individuals aged 65 years and older, insured by the IHIO from 2014 to 2017. Individuals with incomplete demographic information or lacking medication records in the database were excluded from the analysis.
Prevalence and patterns of polypharmacy, demographic factors associated with polypharmacy, and common drug classes used. Medications were classified using the Anatomical Therapeutic Chemical system. Polypharmacy was defined as the use of five or more medications, with cumulative polypharmacy considering total drug use over time, and consecutive polypharmacy focusing on the frequency of monthly drug use. Logistic regression and association rule mining were applied to explore demographic factors and medication patterns associated with polypharmacy.
Of the study population, 74.9% experienced cumulative polypharmacy over 6 months and 64.6% over 1 month, with 7.6% experiencing consecutive polypharmacy. Females and those aged 75–79 were more prone to polypharmacy. Systemic glucocorticoids were the most commonly used medications (50.02%), followed by HMG-CoA reductase inhibitors (42.73%) and platelet aggregation inhibitors (41.92%). Polypharmacy was most strongly associated with medications related to the alimentary tract and metabolism, cardiovascular system, nervous system and blood and blood-forming organs.
Polypharmacy is highly prevalent among the elderly in Iran, with significant variations by gender, age, insurance fund and region. The findings highlight the need for targeted interventions to manage polypharmacy and improve medication safety in this population.
To explore the experience of primary healthcare (PHC) professionals in their professional role during the pandemic and to describe collective coping strategies.
We conducted a qualitative study using interviews, focus groups and photovoice techniques from February to September 2021. The qualitative data were transcribed, aggregated and analysed, from a hermeneutic perspective, using applied thematic analysis and ethnographic approaches.
Primary Care Health Madrid region (Spain).
Convenience sampling was used to select 71 multidisciplinary primary care professionals who were working in 12 PHCs representing diverse socioeconomic, social vulnerability and COVID impact levels in the Madrid region (Spain).
Findings from this study show how lack of protection in the early days, uncertainty about how the disease would evolve and the daily challenges they faced have had an impact on the participants’ perceptions of their professional role. Nuanced differences in impact were found between men and women, age groups, professional roles and territories. The questioning of the basic foundations of primary care and the lack of prospects led to a feeling of demotivation. They perceive a wide gap between their levels of involvement and commitment, the recognition they receive and the attention to resources they need to do their work to a high standard. The support of their colleagues was seen as the most valuable resource for coping with the crisis.
The practitioners’ discourses offer knowledge that could help to face new global health threats; they also identify an urgent need to restore the role and motivation of PHC professionals as part of a wider regeneration of health systems.
Admission to a surgical intensive care unit (ICU) following major surgery is associated with a number of discomforts, not only related to the disease itself but also to the care provided or the ICU environment itself (lights, sounds, pain, sleep deprivation, thirst, etc). This discomfort is real and can be associated with psychological consequences. We hypothesised that the use of immersive virtual reality (IVR) with HypnoVR is feasible and can help reduce discomfort in intensive care.
The ZION trial is a prospective, monocentric trial randomising 194 patients admitted to a surgical ICU after a major surgery. The inclusion criterion is patients admitted to a surgical ICU for at least 48 hours following major surgery (cardiac, thoracic or major abdominal surgery). Patients will be allocated to the intervention group (n=97) or the control group (n=97). In the intervention group, patients will receive IVR using HypnoVR two times a day during the ICU stay (2–5 days). In the control group, postoperative care will be conducted according to standard care without IVR. The primary endpoint will be the 18-item IPREA (Inconforts des Patients de REAnimation) questionnaire on the day of ICU discharge. The secondary endpoints will include intensity of discomfort symptoms (anxiety, pain, dyspnoea, thirst and sleep deprivation); the 18-Item IPREA Questionnaire assessed daily from randomisation to the V1 follow-up visit (ICU discharge); incidence of delirium; cumulative morphine consumption at ICU discharge; length of ICU stay and anxiety or depression at 1 month after discharge from intensive care and patient experience of device use.
Ethical approval was obtained from the institutional review board of the University Hospital of Amiens (Registration number ID: 2024-A01528-39) in January 2025.
by Dipankar Sardar, Istiaq Morol, Johra Bari, Amalan Sarkar, Adnan Habib
Probiotics, particularly strains from the genera Bacillus, Lactobacillus, and Staphylococcus, play a vital role in gut health, immune modulation, and pathogen inhibition. However, environmental stressors during storage often compromise their long-term viability and probiotic functionality. By examining how lyophilization affects the viability and probiotic functionality of certain strains of Bacillus, Lactobacillus, and Staphylococcus, this study sought to understand how storage conditions and protective agents affect bacterial survival and important probiotic characteristics. The bacterial strains were isolated from the gastrointestinal tract of native chickens, cultivated in MRS broth, subjected to freeze-drying with different cryoprotectant formulations, and stored at varying temperatures (4°C, −20°C, and −80°C) for up to 12 months. Survival rates, stress resistance under simulated gastric and intestinal conditions, and probiotic functionality were evaluated over time. The results demonstrated that ultra-low temperature storage (−80°C) combined with a formulation of 5% glucose, 5% sucrose, 7% skim milk powder, and 2% glycine provided optimal protection. This combination effectively reduced oxidative and gastrointestinal stress and preserved key probiotic traits, including adhesion potential, antimicrobial activity, and metabolic stability. Conversely, strains stored without cryoprotectants or at higher temperatures exhibited significant viability loss and functional decline. The study highlights the critical role of optimized cryoprotection in maintaining probiotic efficacy during long-term storage. Our findings reinforce the necessity of selecting appropriate excipients and storage conditions to sustain probiotic efficacy, providing valuable insights for the development of stable, high-quality probiotic formulations. Future research should explore strain-specific responses to lyophilization and alternative preservation strategies to improve probiotic stability and performance.by Weam Mohamed Meargni Ahmed, Malaz M. Abdalmotalib, Mohamed H. Elbadawi, Galia Tajelsir Fadulelmula Mohammed, Waad Mohamed Ibrahim Mohamed, Fatima Salih Babiker Mohammed, Hajar Saad Salih, Hiba Omer Yousif Mohamed
BackgroundArtificial intelligence (AI) is revolutionizing education globally, yet its adoption in medical education remains inadequately understood. ChatGPT, a generative AI tool, offers promising yet doubtful potential for enhancing academic and clinical training.
MethodsThis study employed an analytical cross-sectional design, involving 1,443 Sudanese medical students who participated through an online, structured questionnaire. The questionnaire was designed to assess ChatGPT awareness, usage, and associated factors. Statistical analysis was performed using SPSS software to identify key determinants influencing ChatGPT awareness and usage among the participants.
ObjectiveThis study investigates the levels of awareness, attitude, and usage of ChatGPT among Sudanese medical students, identifying key socio-demographic, economic, and institutional factors influencing its adoption.
ResultsAmong the participants, 65.8% were aware of ChatGPT, yet only 41.9% reported using it. Gender differences were statistically significant, with males demonstrating higher usage rates (p 300,000 SDGs) showed significantly greater usage (p Conclusions
The findings underscore the urgent need for targeted interventions, including curriculum reform to integrate AI literacy, enhanced digital infrastructure, and gender-equity initiatives. Addressing these systemic gaps will scale up AI adoption in medical education. This study provides actionable insights for educators and policymakers, emphasizing the urgency of bridging socio-economic and institutional inequities to foster equitable access to AI tools in medical training.
This study aimed to investigate the association between the type and severity of disabilities and depression among adolescents aged 15–17 years living in underdeveloped areas of Indonesia.
Cross-sectional study.
Data were derived from the 2018 Indonesia Basic Health Research, a nationally representative data of Indonesia.
We used information collected from 4811 adolescents aged 15–17 living in underdeveloped areas of Indonesia.
The primary outcome was depression, based on the conditions experienced by respondents during the last 2 weeks.
The analysis showed that 5.65% of adolescents aged 15–17 years living in underdeveloped areas of Indonesia had depressive symptoms. Adolescents with severe physical and psychological disabilities were most at risk, exhibiting significantly higher odds of developing depression (aOR=12.09, 95% CI: 5.41 to 27.03, p0.001). Other significant predictors included female adolescents (aOR=2.18, 95% CI: 1.51 to 3.14, p0.001) and those who had a non-communicable disease (aOR=3.50, 95% CI: 1.00 to 12.18, p=0.049).
These findings highlight the critical need for targeted depression interventions and collaborative efforts to support vulnerable adolescents in underdeveloped areas of Indonesia, particularly those with disabilities, girls and those with non-communicable diseases. Efforts to engage healthcare providers, educators and policymakers to improve access to mental health resources will enhance the overall well-being of vulnerable populations.
by Judy Malas, Sarah C. Khoury, Michael Tanzillo, Gracie A. Fischer, Jean E. Bogner, D’Arcy R. Meyer-Dombard
Municipal solid waste (MSW) landfills represent underexplored microbial ecosystems. Landfills contain variable amounts of antibiotic and construction and demolition (C&D) wastes, which have the potential to alter microbial metabolism due to biocidal or redox active components, and these effects are largely underexplored. To circumvent the challenge of MSW heterogeneity, we conducted a 65-day time series study on simulated MSW microcosms to assess microbiome changes using 16S rRNA sequencing in response to 1) Fe(OH)3 and 2) Na2SO4 to represent redox active components of C&D waste as well as 3) antibiotics. The addition of Fe(OH)3 altered the overall community composition and increased Shannon diversity and Chao1 richness. The addition of a mixture of seven antibiotics (1000 ng/L each) altered the community composition without affecting diversity metrics. Sulfate addition had little effect on microbial community composition or diversity. These results suggest that the microbial community composition in fresh MSW may be significantly impacted by influxes of iron waste and a single application of antibiotics.by Malak Ghezzawi, Sasha Fahme, Salpy Naalbandian, Jocelyn DeJong, WOMENA Study Group
IntroductionThe Middle East and North Africa (MENA) is a global outlier both for its low female labor force participation and investment in early childhood development services, and consistently ranks lowest on global rankings of gender parity. While the impact of the COVID-19 pandemic on global gender inequity has been acknowledged, specific challenges faced by partnered-women in MENA are underexplored. Additionally, with over half of the region affected by conflict and displacement, exploring these impacts sheds light on understudied gender disparities in humanitarian contexts during the pandemic. This scoping review aims to examine intra-household gender disparities during the COVID-19 pandemic, adding to a more comprehensive understanding of this particular public health emergency’s worldwide ramifications. The hypothesis is that the pandemic has exacerbated women’s pre-existing constraints in the MENA region, worsening gender inequities in economic empowerment, healthcare access, and general well-being.
MethodsThis review will explore intra-household gender disparities in decision-making, household labor division, economic independence, health, and access to resources and services during the COVID-19 pandemic that have been reported to have been affected by COVID-19 globally. Following PRISMA guidelines for Scoping Reviews, a comprehensive search will be conducted in APA PsycINFO, Arab World Research Source: Al Masdar, EconLit, Global Health, MEDLINE, Scopus, and Web of Science Core Collection, in consultation with an information specialist. Studies in English, French and Arabic from January 2020 to August 2024 will be included. Four independent reviewers will screen studies, and data will be charted, coded, and narratively synthesized.
DiscussionThis review is expected to shed light on gender disparities in healthcare accessibility, mobility, and decision-making during the COVID-19 pandemic across low- and middle-income countries in the MENA region, adding to the global literature.
To obtain an in-depth understanding of the lived experiences, values, and beliefs of Taiwanese women with breast cancer who withdrew from cancer treatment.
Fear of side effects, negative experiences and personal beliefs were identified as reasons for withdrawing from cancer treatments. Body–mind consciousness and body autonomy play a crucial role in cancer treatment decisions.
Descriptive phenomenological approach.
We conducted semi-structured, face-to-face and in-depth interviews with 16 women diagnosed with breast cancer. Participants were purposefully selected from the Cancer Registry database. Employing a phenomenological approach, our aim was to explore the lived experiences of these individuals. Data analysis followed Giorgi's five-step process. To ensure a comprehensive report the COREQ checklist was applied.
‘The Determination to Preserve Me’ is the essence of treatment withdrawal, identified by three themes and seven sub-themes. ‘Raising Body-Mind Consciousness’ was generated using body autonomy and preventing repeated psychological trauma from the participant's view. Their lifestyles, maintaining the family role, and returning to a normal trajectory help develop ‘Maintaining Stability for Being a Patient and a Family Carer’. ‘Self-Defending Against the Body Harm’ was generated by concerns about maintaining health and preventing harm.
Women's behaviours became transformed by suffering. Actions were influenced by physical and psychological distress, misconceptions about treatments, and appearance changes by self-determination through self-protection.
Healthcare professionals should respect women's autonomy and work collaboratively to ensure their decision-making with accurate information and awareness of the potential risks and benefits of treatment withdrawal need to concern.
Diabetic foot ulcer is a debilitating complication of long-standing diabetes mellitus. Patients lose their earning potential, face repeated hospitalizations, and are forced to bear heavy treatment costs. This places an enormous financial burden on the patients and their families. This study seeks to ascertain the out-of-pocket expenditure among these patients and correlate it with their risk factor profile. In this hospital-based cross-sectional study, a total of 154 patients with diabetic foot ulcers or amputations have been studied with an elaborate patient questionnaire and relevant clinical examinations. The costs incurred and the risk factors of the patients were analyzed for statistical association. The median total annual out-of-pocket expenditure for the management of diabetic foot ulcers among the study participants was found to be ₹29 775 (₹9650–₹81 120) ($378.14 [$122.56–$1030.22]). Out of the total expenditure, 58.49% went towards direct medical costs, 5.64% towards direct non-medical costs, and 35.88% for indirect costs. Medications, ulcer dressing and periodic debridement have accounted for 79.26% of direct medical costs. Transportation (61.37%) and patient's loss of income (89.45%) account for the major costs under the direct non-medical and indirect cost categories, respectively. A high ulcer grade and area, long ulcer duration, and past history of ulcers have higher expenditure. Patients seeking treatment from private establishments and those engaged in professional/skilled occupations have higher expenses. Adequate dressing of foot ulcers and proper footwear are associated with lower treatment expenditure. 68.8% of the participants have faced catastrophic expenditure due to treatment costs of diabetic foot ulcers. Adequate glycaemic control and proper foot care are necessary. Patients must seek medical care at the earliest in case of foot ulceration. Clinicians must provide proper wound care, institute effective antibiotics, and manage the complications. Government and insurance schemes are required to alleviate the patients' financial burden.
Several studies have reported the prevalence of overweight and obesity in various countries but the global prevalence of nurses with overweight and obesity remains unclear. A consolidation of figures globally can help stakeholders worldwide improve workforce development and healthcare service delivery.
To investigate the global prevalence of overweight and obesity among nurses.
Systematic review with meta-analysis.
29 different countries across the WHO-classified geographical region.
Nurses.
Eight electronic databases were searched for articles published from inception to January 2023. Two independent reviewers performed the article screening, methodological appraisal and data extraction. Methodological appraisal was conducted using Newcastle-Ottawa Scale (NOS). Inter-rater agreement was measured using Cohen's Kappa. Meta-analyses were conducted to pool the effect sizes on overweight, obesity and waist circumference using random effects model and adjusted using generalised linear mixed models and Hartung–Knapp method. Logit transformation was employed to stabilise the prevalence variance. Subgroup analyses were performed based on methodological quality and geographical regions. Heterogeneity was assessed using the I 2 statistic.
Among 10,587 studies, 83 studies representing 158,775 nurses across 29 countries were included. Based on BMI, the global prevalence of overweight and obesity were 31.2% (n = 55, 95% CI: 29%–33.5%; p < .01) and 16.3% (n = 76, 95% CI: 13.7%–19.3%, p < .01), respectively. Subgroup analyses indicated that the highest prevalence of overweight was in Eastern Mediterranean (n = 9, 37.2%, 95% CI: 33.1%–41.4%) and that of obesity was in South-East Asia (n = 5, 26.4%, 95% CI: 5.3%–69.9%). NOS classification, NOS scores, sample size and the year of data collected were not significant moderators.
This review indicated the global prevalence of overweight and obesity among nurses along with the differences between regions. Healthcare organisations and policymakers should appreciate this increased risk and improve working conditions and environments for nurses to better maintain their metabolic health.
Not applicable as this is a systematic review.
PROSPERO (ref: CRD42023403785) https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=403785.
High prevalence of overweight and obesity among nurses worldwide.
Objetivo: recopilar evidencia científica sobre la implementación y evaluación del uso de instrumentos para la identificación temprana del deterioro clínico en pacientes no infectados por SARS-COV-2 en unidades de hospitalización de adultos. Método: revisión integradora realizada en las bases de datos Latin American and Caribbean Literature on Health Sciences, Medical Literature Analysis and Retrieval System Online, Web Of Science y SCOPUS, utilizando la siguiente estrategia de búsqueda: (“Early Medical Intervention” OR “Early Warning Systems” O “Puntuación de alerta temprana”) Y (“Deterioro clínico”). Resultados: se seleccionaron ocho artículos que abordaron la implementación de herramientas para la identificación temprana de deterioro clínico en unidades de hospitalización y evaluaron sus resultados a través de indicadores de incidencia de paro cardiorrespiratorio, incidencia de ingreso no planificado en UTI, incidencia de cirugía de emergencia, mortalidad e incidencia de enfermedad renal. lesión. Conclusión: la implementación de herramientas que permiten la identificación temprana del deterioro clínico en las unidades de hospitalización tuvo un impacto positivo en los indicadores institucionales.
Objetivo. Analizar factores relacionados con la conducta suicida en pacientes con enfermedad mental para orientar la prevención y cuidados de salud mental especializados. Material y métodos. Estudio descriptivo transversal de una muestra de 44 pacientes hospitalizados por conducta suicida en psiquiatría. Durante 12 meses se registraron variables sociodemográficas y clínicas, se aplicaron la escala Columbia de cribado del riesgo suicida, la de Desesperanza de Beck, la de Impulsividad de Plutchik y el Inventario de Razones para Vivir. Se usó estadística descriptiva e inferencial para una significación estadística de p<0,05. Resultados. El 84% (n=37) presentó ideación suicida, el 63,3% (n=28) tentativa y el 2,3% (n=1) suicidio consumado. Realizaron más intentos previos las mujeres (60%/n=15) que los hombres (38%/n=7). La intoxicación medicamentosa fue el método más utilizado por ambos sexos seguido de autolesiones por mujeres (p<0,05) y precipitación por hombres (p<0,05). La depresión, trastorno más prevalente, se asoció a la edad y al medio rural (p<0,05). El trastorno de ansiedad fue el más predictivo para la intención/plan y tentativas suicidas (p<0,05). El 80% (n=16) de los intentos padecía enfermedad médica (p<0,05). Se evidenció la relación inversa entre las creencias de supervivencia/afrontamiento y la conducta suicida. Discusión. La conducta suicida supone más del 20% de los ingresos de una unidad psiquiátrica. No es posible determinar un perfil único de riesgo, se han evidenciado diferencias según el espectro suicida. Todos los factores relacionados deben ser valorados.
ABSTRACT
Objective. To analyze factors related to suicidal behavior in patients with mental illness to guide prevention and specialized mental health care. Methodology. A descriptive cross-sectional study carried out in a sample of 44 inpatients at a psychiatric unit who attempted suicide. Sociodemographic and clinical variables were registered during 12 months. The scales applied were the Columbia-Suicide Severity Rating Scale (C-SSRS), Beck Hopelessness Scale, Plutchik’s Impulsivity Scale and the Reasons for Living Inventory. A descriptive and inferential statistic has been applied for a statistical significance of p<0,05. Results. 84% (n=37) had suicidal thinking, 63,3% (n=28) attempted suicide and 2,3% (n=1) committed suicide. More women (60%; n=15) than men (38%; n=7) attempted suicide. Medication overdose was the main suicidal approach by both sexes followed by self-harm by women (p<0,05) and deliberate fall by men (p<0,05). Depression, the most prevalent disorder, was associated with age and rural environment (p<0,05). Anxiety had the highest predictive value of suicidal attempt (p<0,05). 80% (n=16) of those who attempted suicide suffered from a medical illness (p<0,05). There is evidence of inverse relationship between the survival and coping beliefs and the suicidal behaviour. Discussion. Suicidal behaviour surpasses 20% of the admissions at a psychiatric unit. It is not possible to determine a specific risk profile as differences according to the suicidal spectrum have been acknowledged. Every possible cause must be evaluated.
FreshRSS 