Sources of psychological distress among primary care physicians during the COVID-19 pandemic’s first wave in Spain: a cross-sectional study

Abstract Background: The COVID-19 pandemic is affecting people worldwide. In Spain, the first wave was especially severe. Objectives: This study aimed to identify sources and levels of distress among Spanish primary care physicians (PCPs) during the first wave of the pandemic (April 2020). Methods: A cross-sectional study was conducted using a survey that included sociodemographic data, a description of working conditions related to distress [such as gaps in training in protective measures, cleaning, and hygiene procedures in work setting, unavailability of personal protective equipments (PPEs) and COVID-19 RT-PCR test, and lack of staff due to be infected] and a validated scale, the ‘Self-applied Acute Stress Scale’ (EASE). The survey was answered by a non-probability sampling of PCPs working in family healthcare centres from different regions of Spain. Analysis of variance and multivariate linear regression analysis were performed. Results: In all, out of 518 PCP participants, 123 (23.7%) obtained high psychological distress scores. Only half of them had received information about the appropriate use of PPE. PCP characteristics associated with higher levels of distress include female gender [1.69; 95% confidence interval (CI) 0.54, 2.84]; lack of training in protective measures (1.96; 95% CI 0.94, 2.99); unavailable COVID-19 RT-PCR for health care workers after quarantine or COVID-19 treatment (−0.77 (−1.52, −0.02). Reinforcing disinfection of the work environment (P < 0.05), availability of PPEs (P < 0.05), and no healthcare professional was infected (P < 0.05) were related to the lowest distress score. Conclusions: A better understanding of the sources of distress among PCPs could prevent its effect on future outbreaks.

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Psychological distress and associated factors related to COVID-19 pandemic among primary care physicians in Spain (STREPRIC study)

10.21203/rs.3.rs-27476/v2 ◽

2020 ◽

Author(s):

Cebrián-Cuenca M Ana ◽

Jose Joaquin Mira ◽

Elena Caride-Miana ◽

Antonio Fernández-Jiménez ◽

Domingo Orozco-Beltrán

Keyword(s):

Primary Care ◽

Health Care ◽

Psychological Distress ◽

Primary Care Physicians ◽

Linear Regression Analysis ◽

Health Care Facilities ◽

Multivariate Linear Regression Analysis ◽

Rt Pcr ◽

Protective Measures ◽

Factors Associated

Abstract Background The COVID-19 pandemic is affecting people in all nations worldwide. In Spain, the epidemic has become especially severe. The lack of protective measures is a major concern and may have caused emotional stress to Primary Care Physicians (PCPs). This study aimed to address the sources of psychological distress among Spanish PCPs during the COVID-19 pandemic.Methods This observational, cross sectional study was conducted using a survey questionnaire that consisted of 24 expressions to be answered by PCPs working in family healthcare centres in Spain during the pandemic. A specific scale, the “Examination of Anomalous Self-Experience”, EASE scale was used to determine the distress related to the care of COVID-19 patients among Spanish PCPs. A multivariate linear regression analysis was performed.Results In all, 518 PCPs belonging to different regions of Spain participated in this survey, of which 123 (23.7%) obtained high psychological distress scores. Only half of them had received information about the appropriate use of personal protective equipment (PPE). PCPs factors associated with higher levels of distress include female gender (1.69; CI 0.54, 2.84); Age (-0.43 (-0.61, 1.48)); working setting (rural) (0.84 (-0.34, 2.01)); lack of training in protective measures (1.96 (0.94, 2.99)). The absence of sick leave among colleagues, increased availability of PPEs, improved cleaning and hygiene conditions in health care centers facilities and the detection of COVID-19 RT-PCR for health care workers were associated with lower levels of distress.Conclusions One in four PCPs rated a high score for psychological distress. The availability of PPEs, training on their use, cleanliness and hygiene conditions in health care facilities and the availability of COVID-19 RT-PCR analyses for health workers, among others, are factors associated with the psychological distress of PCPs.

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Psychological distress and associated factors related to COVID-19 pandemic among primary care physicians in Spain (STREPRIC study)

10.21203/rs.3.rs-27476/v1 ◽

2020 ◽

Author(s):

Cebrián-Cuenca M Ana ◽

Jose Joaquin Mira ◽

Elena Caride-Miana ◽

Antonio Fernández-Jiménez ◽

Domingo Orozco-Beltrán

Keyword(s):

Primary Care ◽

Health Care ◽

Psychological Distress ◽

Primary Care Physicians ◽

Health Care Facilities ◽

Multivariate Linear Regression Analysis ◽

Rt Pcr ◽

Protective Measures ◽

Factors Associated ◽

Health Care Centers

Abstract Background The COVID-19 pandemic is affecting people in all nations of the world. In Spain, the epidemic is being especially harsh. The lack of protective measures is a major concern and may have caused emotional stress to Primary Care Physicians (PCPs). The aim of the study was to address the sources of psychological distress among Spanish PCPs during the COVID-19 pandemic. Methods Observational, cross sectional study. A questionnaire consisting of 24 expressions was answered by PCPs working in their family health care centers in Spain during COVID-19 pandemic. A specific scale (EASE scale) was used to determine psychological distress, recently validated in the context of this pandemic. A Multivariate Linear Regression analysis was performed. Results 518 PCPs from different Spanish regions, participated in this survey. A total of 123 (23.7%) rated a high psychological distress score. Only half of PCPs received information about the appropriate use of Personal Protective Equipment (PPE). PCPs factors associated with higher levels of distress include female gender (1.69; CI 0.54, 2.84); Age (-0.43 (-0.61, 1.48)); working setting (rural) (0.84 (-0.34, 2.01)); lack of training in protective measures (1.96 (0.94, 2.99)). The absence of sick leave among colleagues, increased availability of PPEs, improved cleaning and hygiene conditions in health care centers facilities and the detection of COVID-19 RT-PCR for health care workers were associated with lower levels of distress. Conclusions One in four PCPs rated a high score for psychological distress. The availability of PEPs, training in their use, cleanliness and hygiene conditions in health care facilities and the availability of COVID-19 RT-PCR analyses for health workers, among others, are factors associated with the psychological distress of PCPs.

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The relationship between the atherogenic index of plasma and arterial stiffness in essential hypertensive patients from China: a cross-sectional study

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02049-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Juan Yin ◽

Minghui Li ◽

Lingling Yu ◽

Feng Hu ◽

Yu Yu ◽

...

Keyword(s):

Essential Hypertension ◽

Arterial Stiffness ◽

Linear Regression Analysis ◽

Cross Sectional Study ◽

Atherogenic Index ◽

Chinese Patients ◽

Multivariate Linear Regression Analysis ◽

Sectional Study ◽

Cross Sectional ◽

Atherogenic Index Of Plasma

Abstract Background The atherogenic index of plasma (AIP) always remains in a potential association with arterial stiffness, however, this association has not been fully discovered and needs to be studied in depth in large hypertensive patient populations. The present analysis thus sought to further explore the association that exists between AIP and arterial stiffness in Chinese patients diagnosed with arterial hypertension. Methods This cross-sectional study analyzed 4744 Chinese individuals with essential hypertension. AIP was defined as the base 10 logarithm of the ratio of plasma of triglycerides to high-density lipoprotein cholesterol levels indicated in molar concentrations. Measurement of arterial stiffness was carried out via brachial-ankle pulse wave velocity (baPWV). Results Data were adjusted for potential confounding variables, and multivariate linear regression analysis revealed AIP to be positively correlated with baPWV (β = 1.34, 95% CI: 0.96 to 1.72, P < 0.001). When AIP was instead treated as a categorical variable divided into quartiles, the same relationship was observed (P for trend < 0.001). We additionally found AIP and baPWV had a stronger positive association in individuals with a body mass index (BMI) < 24 kg/m2 (P for interaction < 0.05). Conclusion AIP and arterial stiffness were positively correlated in essential hypertension patients in China, especially in those with a BMI < 24 kg/m2. Clinical trial registration ChiCTR1800017274.

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Knowledge, attitude and practice of evidence-based medicine among primary care practitioners in Malaysia: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-044372 ◽

2021 ◽

Vol 11 (6) ◽

pp. e044372

Author(s):

Mat Nawi Zanaridah ◽

Mohd Noor Norhayati ◽

Zakaria Rosnani

Keyword(s):

Primary Care ◽

Evidence Based Medicine ◽

Primary Care Physicians ◽

Cross Sectional Study ◽

Evidence Based ◽

Sectional Study ◽

Primary Care Practitioner ◽

Cross Sectional ◽

Primary Care Practitioners ◽

Based Medicine

ObjectivesTo determine the level of knowledge and practice of evidence-based medicine (EBM) and the attitudes towards it and to identify the factors associated with its practice among primary care practitioners in Selangor, Malaysia.SettingThis cross-sectional study was conducted in randomly selected health clinics in Selangor. Data were collected from primary care physicians using self-administered questionnaires on knowledge, practice and attitudes regarding EBM.ParticipantsThe study included 225 respondents working in either government or private clinics. It excluded house officers and those working in public and private universities or who were retired from practice.ResultsA total of 32.9% had a high level of EBM knowledge, 12% had a positive attitude towards EBM and 0.4% had a good level of its practice. The factors significantly associated with EBM practice were ethnicity, attitude, length of work experience as a primary care practitioner and quick access to online reference applications on mobile phones.ConclusionsAlthough many physicians have suboptimal knowledge of EBM and low levels of practising it, majority of them have a neutral attitude towards EBM practice. Extensive experience as a primary care practitioner, quick access to online references on a mobile phone and good attitude towards EBM were associated with its practice.

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The Relationship Between the Atherogenic Index of Plasma and Arterial Stiffness in Essential Hypertensive Patients from China: A Cross-Sectional Study

10.21203/rs.3.rs-215251/v1 ◽

2021 ◽

Author(s):

Juan Yin ◽

Minghui Li ◽

Lingling Yu ◽

Feng Hu ◽

Yu Yu ◽

...

Keyword(s):

Essential Hypertension ◽

Arterial Stiffness ◽

Linear Regression Analysis ◽

Density Lipoprotein ◽

Cross Sectional Study ◽

Atherogenic Index ◽

Multivariate Linear Regression Analysis ◽

Sectional Study ◽

Cross Sectional ◽

Atherogenic Index Of Plasma

Abstract Background: The atherogenic index of plasma (AIP) always remains in a potential association with the arterial stiffness, however, in large hypertensive patient populations, this relation is not fully discovered and needs to be studied in depth. The present analysis thus sought to further explore the association that exists between AIP and arterial stiffness in patients diagnosed with arterial hypertension in China.Methods: This cross-sectional study analyzed 4744 Chinese individuals with essential hypertension. AIP was defined as the base 10 logarithm of the ratio of plasma of triglycerides (TG) to high-density lipoprotein cholesterol (HDL-c) levels indicates as in molar concentrations. Measurement of arterial stiffness was carried out via brachial-ankle pulse wave velocity (baPWV).Results: Data were adjusted for potential confounding variables, after which a multivariate linear regression analysis revealed AIP to be positively correlated with baPWV (β = 1.34, 95% CI: 0.96 to 1.72, P < 0.001). When AIP was instead treated as a categorical variable divided into quartiles, this same relationship was observed (P for trend < 0.001). We additionally found AIP and baPWV had a stronger positive association in individuals with a body mass index (BMI) < 24 kg/m2 (P for interaction < 0.05).Conclusion: AIP and arterial stiffness were positively correlated in essential hypertension patients in China, especially in those with a BMI < 24 kg/m2.

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Variation in colorectal cancer testing between primary care physicians: a cross-sectional study in Switzerland

International Journal of Public Health ◽

10.1007/s00038-019-01259-4 ◽

2019 ◽

Vol 64 (7) ◽

pp. 1075-1083 ◽

Cited By ~ 3

Author(s):

Alexander Leonhard Braun ◽

Emanuele Prati ◽

Yonas Martin ◽

Charles Dvořák ◽

Kali Tal ◽

...

Keyword(s):

Colorectal Cancer ◽

Primary Care ◽

Primary Care Physicians ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Diabetes care knowledge and practice among primary care physicians in Southeast Nigeria: a cross-sectional study

BMC Family Practice ◽

10.1186/s12875-020-01202-0 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Ejiofor Ugwu ◽

Ekenechukwu Young ◽

Marcellinus Nkpozi

Keyword(s):

Primary Care ◽

Diabetes Care ◽

Primary Care Physicians ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Knowledge And Practice

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Longer shared parental leave is associated with longer duration of breastfeeding: a cross-sectional study among Swedish mothers and their partners

BMC Pediatrics ◽

10.1186/s12887-020-02065-1 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Maria Grandahl ◽

Jenny Stern ◽

Eva-Lotta Funkquist

Keyword(s):

Linear Regression ◽

Parental Leave ◽

Linear Regression Analysis ◽

Cross Sectional Study ◽

Vaginal Birth ◽

Breastfeeding Duration ◽

Multivariate Linear Regression Analysis ◽

Sectional Study ◽

Cross Sectional ◽

Duration Of Breastfeeding

Abstract Background Breastfeeding is associated with health benefits for both the mother and infant and is therefore important to support; moreover, parental leave is a beneficial factor for breastfeeding. The Swedish parental leave is generous, allowing each parent to take 90 days; additionally, a further 300 days can be taken by either parent. Generally, mothers take 70% of the parental leave days, mainly during the first year. However, breastfeeding duration has declined in the last decade, and it is not known how shared parental leave is associated with the duration of breastfeeding. Aim To investigate how parental leave is associated with the duration of exclusive and partial breastfeeding of the infant during the first 12 months after birth. An additional aim was to describe infants’ and parents’ characteristics and mode of birth in association with the duration of exclusive and partial breastfeeding. Methods This cross-sectional study was part of the Swedish Pregnancy Planning Study, conducted in Sweden in 2012–2015. The parents were recruited at 153 antenatal clinics in nine counties. In total, 813 couples completed a follow-up questionnaire 1 year after birth. Linear regression models were used to analyse the association between parental leave and the duration of breastfeeding. Results Infants were exclusively breastfed for, on average, 2.5 months (range 0–12 months) and partially breastfed, on average, 7 months (range 0–12 months). Most of the parental leave was taken by the mother (mean = 10.9 months) during the infant’s first 12 months, while the partner took 3 months, on average. The parental leave (used and planned) during the infant’s first 24 months were, on average, 21 months. In the multivariate linear regression analysis, mothers’ and partners’ high level of education (p < 0.001, p = 0.044, respectively), mothers’ higher age (p = 0.049), non-instrumental vaginal birth (p = 0.004) and longer parental leave for the first 24 months (p < 0.001) were associated with longer duration of partial breastfeeding. Conclusion The duration of partial breastfeeding was associated with higher parental educational level, higher age, non-instrumental vaginal birth and longer parental leave.

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Nutrition competence of primary care physicians in Saudi Arabia: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-033443 ◽

2020 ◽

Vol 10 (1) ◽

pp. e033443 ◽

Cited By ~ 1

Author(s):

Osamah Al-gassimi ◽

Hassan Bin Usman Shah ◽

Rawan Sendi ◽

Heba A Ezmeirlly ◽

Lauren Ball ◽

...

Keyword(s):

Primary Care ◽

Chronic Disease ◽

Primary Care Physicians ◽

Cross Sectional Study ◽

Nutrition Knowledge ◽

Sectional Study ◽

Cross Sectional ◽

Knowledge And Skills ◽

Nutrition Care ◽

Dietary Behaviours

ObjectivesPrimary care physicians have an opportunity to support healthy dietary behaviours of patients by providing nutrition care. However, it is unclear whether primary care physicians in the Kingdom of Saudi Arabia (KSA) are sufficiently competent in nutrition. This study aimed to assess the nutrition competence of primary care physicians in KSA and identify whether nutrition competence is associated with the provision of nutrition care to patients living with diet-related chronic disease.DesignA cross-sectional study.SettingChronic disease clinics across 48 primary care centres under the Ministry of Health in the city of Jeddah, KSA.Participants90 primary care physicians completed the survey (response rate: 98%). General practitioners and family medicine residents, specialists, and consultants actively working in chronic disease clinics between February and May 2019 were included.Primary and secondary outcome measuresPrimary outcome measure was nutrition competence of primary care physicians measured via the validated nutrition competence (NUTCOMP) questionnaire.ResultsPrimary care physicians perceived themselves as competent in nutrition care but their reported provision of nutrition care was limited. Confidence in their nutrition knowledge and skills elicited the lowest mean scores of 25.8 (±5.4) out of 35 and 29 (±5.2) out of 40, respectively. The reported provision of nutrition care was closely correlated with physicians’ confidence in their nutrition knowledge (r=0.57) and communication (r=0.52). Three factors were identified as predicting whether physicians provide nutrition care to patients: confidence in counselling about nutrition (p<0.001), having previous nutrition education (p=0.005) and a higher professional qualification (p=0.008).ConclusionsPrimary care physicians felt confident in providing nutrition care to patients living with diet-related chronic disease. Primary care physicians would benefit from higher levels of nutrition knowledge and skills to effectively support patients to improve their dietary behaviours and health conditions, leading to a positive impact on public health.

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