Salud mental

Salud 精神
  • 文章类型: Consensus Development Conference
    BACKGROUND: The crisis situation generated by COVID-19 and the measures adopted have generated social changes in the normal dynamics of the general population and especially for health workers, who find themselves caring for patients with suspected or confirmed infection. Recent studies have detected in them depression and anxiety symptoms and burnout syndrome, with personal and social conditions impacting their response capacity during the health emergency. Our aim was to generate recommendations for the promotion and protection of the mental health of health workers and teams in the first line of care in the health emergency due to COVID-19.
    METHODS: A rapid literature search was carried out in PubMed and Google Scholar, and an iterative expert consensus and through electronic consultation, with 13 participants from the areas of psychology, psychiatry and medicine; the grading of its strength and directionality was carried out according to the international standards of the Joanna Briggs Institute.
    RESULTS: Thirty-one recommendations were generated on self-care of health workers, community care among health teams, screening for alarm signs in mental health and for health institutions.
    CONCLUSIONS: The promotion and protection activities in mental health to face the health emergency generated by COVID-19 worldwide can include coordinated actions between workers, health teams and health institutions as part of a comprehensive, community care, co-responsible and sustained over time.
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  • 文章类型: Case Reports
    建立实施最佳实践指南“评估和照顾有自杀想法和行为风险的成年人”后护理过程的演变。
    在VirgendelasNieves医院的精神卫生住院部门进行了描述性纵向研究,格拉纳达.2016年至2018年期间入住该单位的所有患者,总计1471名,包括在内。评估了护理过程指标的依从性和自杀风险;此外,获得了每10万居民的自杀率。计算了指标的绝对频率和相对频率,以及卡方皮尔森检验在研究期间的变化,P<0.05。
    我们观察到整个护理过程在统计学上显着增加。自杀风险评估患者的百分比从2016年的16%提高到2018年的45.25%。2018年,安全措施的应用增长到100%,社区服务转诊从70.31%上升到90.50%。有自杀意念风险的患者百分比保持稳定。格拉纳达每10万居民的自杀率下降了24.50%。
    自该指南实施以来,格拉纳达护理过程的改善和自杀率的下降与其他研究的结果一致,并提供了充满希望的愿景。必须推广预防自杀的综合策略,必须继续对所采取的举措进行评估。
    To establish the evolution of the care process after the implementation of the Best Practices Guideline «Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour».
    A descriptive longitudinal study was carried out at the Mental Health Hospitalization Unit in Hospital Universitario Virgen de las Nieves, Granada. All patients admitted to the Unit between 2016 and 2018, 1471 in total, were included. Compliance of care process indicators and suicidal risk were evaluated; in addition, suicide rates per 100,000 inhabitants were obtained. Absolute and relative frequencies of the indicators were calculated, as well as the change during the study period by the chi-square Pearson test, for P<.05.
    We observed a statistically significant increase in the entire care process. The percentage of patients with suicidal risk assessment improved from 16% in 2016 to 45.25% in 2018. The application of safety measures grew reaching 100% in 2018, and community services referral went from 70.31% to 90.50%. The percentage of patients at risk of suicidal ideation remains stable. Suicide rates per 100,000 inhabitants in Granada decreased by 24.50%.
    Improvement in the care process and the decrease in the suicide rate in Granada since the implementation of the guideline are consistent with the results of other research and offer a hopeful vision. Comprehensive strategies for suicide prevention must be promoted, and the evaluation of initiatives undertaken must continue.
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  • 文章类型: Journal Article
    BACKGROUND: There has been a considerable proliferation of clinical guidelines recently, but their practical application is low, and organisations do not always implement their own ones. The aim of this study is to analyse and describe key elements of strategies and resources designed by the National Institute for Health and Care Excellence for the implementation of guidelines for common mental health disorders in adults, which are some of the most prevalent worldwide.
    METHODS: A systematic review was performed following PRISMA model. Resources, tools and implementation materials where included and categorised considering type, objectives, target and scope.
    RESULTS: A total of 212 elements were analysed, of which 33.5 and 24.5% are related to the implementation of generalized anxiety and depression guidelines, respectively. Applied tools designed to estimate costs and assess the feasibility of the setting up at local level are the most frequent type of resource. The study highlights the important variety of available materials, classified into 3 main strategies: tools targeting the professionals (30.6%), structural (26.4%), and organizational (24%).
    CONCLUSIONS: Developing guidelines is not enough; it is also necessary to promote their implementation in order to encourage their application. The resources and strategies described in this study may be potentially applicable to other contexts, and helpful to public health managers and professionals in the design of programmes and in the process of informed decision making to help increase access to efficient treatments.
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