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Introduction: The Geriatric Depression Scale is an instrument used to identify depression in people of an older age. The original English version of this scale has been translated into Spanish (GDS-VE); two shorter versions of 5- (GDS-5) and 15-items (GDS-15) have been developed. Aim of the study: To assess the validity and compare the 5- and 15-item Spanish versions of the GDS among the Spanish population. Materials and methods: 573 Galicia residents aged >50 years participated in this study. The following instruments were applied: the 19-item Control, Autonomy, Self- Realization and Pleasure scale, the Subjective Memory Complaints Questionnaire, the Mini-Mental State Examination test, the GDS-5, and the GDS-15. Results: We found differences in total score between GDS-5 and GDS-15 regarding the variable sex. Internal reliability for GDS-5 and GDS-15 was 0.495 and 0.715, respectively. Sensitivity and specificity for GDS-5 – with a cut-off value of 1 – was 0.517 and 0.650, respectively; for GDS-15 – with a cut-off value of 3 points – sensitivity was 0.755 and specificity 0.668. GDS-5 has a ROC curve of 0.617 and GDS-15 of 0.764. Conclusion: GDS-15, and to a greater extent GDS-5, should be revised or even reformulated to improve their diagnostic usefulness by choosing higher discriminative ability items or even include new items with greater sensitivity that consider currently prevailing psychosocial factors

Introduction and objectives: The experiences and changes that come along with old age may lead to a feeling of loneliness, usually followed by negative physical and mental manifestations. In this systematic review, we evaluated the existing tools to assess loneliness in older adults. Methods: We performed a literature search in the Web of Science, Medline, and PsycINFO, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. After, we examined the psychometric properties of the instruments with a focus on reliability, validity, and main conclusions. Results: We included 27 articles published between 1996 and 2021. Conclusion: To date, there are few instruments to assess loneliness in older adults. In general, they present adequate psychometric properties, although it is true that some scales show somewhat low levels of reliability and validity

The development of immunosuppressants has been key for the advancement of solid organ transplant surgery. Specifically, cyclosporine, tacrolimus, or everolimus have significantly increased the survival rate of patients by reducing the risk of a rejection of the transplanted organ and limiting graft-versus-host disease. We report the case of a 65-year-old man who, after undergoing a liver transplantation and receiving an immunosuppressive treatment with cyclosporine and everolimus, presented severe obsessive, psychotic, and behavioral symptoms over the past three years, and describe the pharmacological and non-pharmacological interventions implemented against these symptoms. In this case, the immunosuppressants used have been cyclosporine and, preferably, everolimus. On the other hand, potential adverse reactions to the treatment have been observed, including neuropsychiatric symptoms such as tremor, anxiety, dysthymia, psychosis, and behavioral disorders, which make it necessary to use corrective psychoactive drugs such as benzodiazepines, antidepressants, and antipsychotics, combined with non-pharmacological interventions. A transversal approach, from the medical and psychosocial disciplines, facilitates success in managing neuropsychiatric symptoms after soft organ transplants

Con la llegada de la pandemia de la Covid-19 los modelos de atención residencial a personas en situación de dependencia, en particular en los centros de larga estancia, han estado en el centro del debate. La población mayor, en general, y en particular, los mayores institucionalizados, fueron los más afectados por la pandemia. Estos hechos derivados de la pandemia, conjuntamente con el cambio en el perfil de los usuarios, hacen necesaria la creación de nuevos modelos que sitúen a la persona mayor en el centro de la atención y asistencia. Objetivo: Poner de manifiesto las debilidades y fortalezas de los modelos de atención residenciales y, conocer el grado de preparación que disponen para enfrentarse a la implantación de estos nuevos modelos. Metodología: La metodología es cualitativa a través de recogida de información mediante entrevistas, observación de trabajadores y usuarios de diferentes centros, además de llevar a cabo una revisión bibliográfica. Resultados: Los resultados se estructuran en 4 dimensiones y 22 categorías en las que se recogen las respuestas de los 30 participantes. Conclusiones: Los centros que han sido objeto de estudio tratan de potenciar la autonomía e independencia de los usuarios aun cuando son conscientes de las deficiencias actuales y se esfuerzan por adaptarse a las características de un modelo más centrado en la persona, With the arrival of the Covid-19 pandemic, residential care models for people in a situation of dependency, particularly in long-term care centers, have been at the center of the debate. The elderly population, in general, and in particular, the institutionalized elderly, were the most affected by the pandemic. These facts derived from the pandemic, together with the change in the profile of users, make it necessary to create new models that place the elderly person at the center of care and assistance. Objective: To highlight the weaknesses and strengths of the current residential care models in small, medium and large centers and to know the degree of preparation they have to face the implementation of these new models. Methodology: The methodology is qualitative through the collection of information through interviews, observation of workers and users of different centers, as well as carrying out a bibliographic review. Results: The results are structured in 4 dimensions and 22 categories in which the responses of the 30 participants are collected. Conclusions: The different models of residential care are adapted to the characteristics of each center, taking into account architectural aspects, location, labor resources and user profiles. Assessing which is better or worse requires a very deep reflection, being very difficult to satisfy everyone

Las adicciones constituyen uno de los principales problemas de salud pública que afectan a los jóvenes españoles. Los elevados niveles de prevalencia, la falta de descensos significativos en las tendencias de consumo, las tempranas edades de inicio y los riesgos asociados hacen pensar en la necesidad de un cambio de paradigma en la labor de los dispositivos de prevención. Diseñar nuevas estrategias que incluyan la detección precoz y la intervención breve podría contribuir a que los dispositivos de Atención Primaria fueran menos reactivos y más proactivos. El modelo SBIRT (Screening, Brief Intervention and Referral to Treatment), que desde hace décadas se viene aplicando en EE. UU., supone un enfoque integral e integrado de Salud Pública, con el que se podrían abordar las adicciones con y sin sustancia, tanto de aquellos jóvenes con trastornos adictivos instaurados, como de aquellos que muestren una elevada probabilidad de desarrollarlos.

SCA (Síndrome Confusional Agudo) o Delirium: es uno de los síndromes cognitivos que más afecta al paciente anciano frágil. El envejecimiento poblacional, ha conducido a que la atención hospitalaria moderna concentre cada vez mayor cantidad de adultos mayores portadoras de diversas condiciones crónicas, que requieren de una atención integral y especializada. Esta entidad constituye una emergencia médica que no se trata adecuadamente. Las cifras epidemiológicas nos alertan de haberse convertido en una problemática entre los clínicos, por su dimensión multicausal y de abordaje terapéutico tardío. El SCA se entiende por un trastorno neuropsiquiátrico que cursa con una alteración transitoria del estado mental, caracterizado por una serie de manifestaciones clínicas, principalmente a nivel de la conciencia y la atención. De aparición aguda (en horas y días) y de curso fluctuante, con alternancia de intervalos lúcidos diurnos y empeoramiento nocturno. Además, pueden verse afectadas otras áreas como la del lenguaje, el pensamiento, la memoria, la percepción, el ciclo sueño-vigilia o la orientación. Suele ser la manifestación de una alteración orgánica subyacente, aunque en la mayoría de los casos su origen es multifactorial. (1) Un ejemplo que nos puede ayudar a situarnos es “el curso de una infección de orina”, “secundario a fractura de cadera”, comportándose como una manifestación atípica, un síntoma, que nos obliga a buscar la causa de la enfermedad base desencadenante. Existen pocos estudios y datos epidemiológicos a nivel de AP, relacionados principalmente con el régimen institucional y la hospitalización. Las cifras de incidencia y prevalencia son muy variables, dependen de varios factores como de la población a estudiar y/o tipo de régimen asistencial, método diagnóstico y de las comorbilidades que puedan surgir y el proceso de cuidados, entre otros. Este comportamiento ensombrece el pronóstico y retrasa el tratamiento. Tiene un importante efecto sobre la salud indiv, Through the following literature review we will define one of the main geriatric clinical syndromes in people over 65 years of age. Delirium or Acute Confusional Syndrome (ACS). ACS (Acute Confusional Syndrome) or Delirium: is one of the cognitive syndromes that most affects the vulnerable elderly patient. The ageing of the population has led to modern hospital care concentrating an increasing number of older adults with various chronic conditions that require comprehensive and specialised care. This entity constitutes a medical emergency that is not adequately treated. Epidemiological figures alert us to the fact that it has become a problem among clinicians, due to its complex multi-causal dimension and delayed therapeutic approach. It is understood as a neuropsychiatric disorder with a transient alteration of the mental state, characterised by a series of clinical manifestations, mainly at the level of consciousness and attention. It has an acute onset (within hours and days) and a fluctuating course, with alternating lucid intervals during the day and worsening at night. In addition, language, thinking, memory, perception, the sleep-wake cycle or orientation may be affected. It is usually the manifestation of an underlying organic disorder, although in most cases its origin is multifactorial. (1) An example that can help us to situate ourselves is "the course of a urinary tract infection" or "secondary to hip fracture", behaving as an atypical manifestation, a symptom, or which itself forces us to look for the cause of the underlying triggering disease. There are few studies and epidemiological data at the PC level, being mainly related to the institutional regime and hospitalisation. Incidence and prevalence figures are highly variable, depending on various factors such as the population to be studied and/or type of care regime, diagnostic method and the comorbidities that may arise and the care process, among others. This behaviour clouds prognosis and delays

Introducción: Las lesiones traumáticas constituyen la segunda causa más común de daño cerebral adquirido. A menudo, la responsabilidad del cuidado de quienes las padecen recae sobre un miembro de la familia, comúnmente una mujer. La atención que este individuo presta comporta una disminución de su calidad de vida. Objetivos: Indagar en la problemática que resulta del cuidado informal y en el impacto que este tiene sobre la persona con daño cerebral traumático. Analizar la efectividad de las intervenciones del personal sanitario. Metodología: Se realizaron 28 búsquedas avanzadas en 5 bases de datos. A partir de los resultados obtenidos se llevaron a cabo tres selecciones, obteniendo 21 artículos sobre los que se realizó una exhaustiva revisión bibliográfica. Resultados: Del cuidado se derivan nuevas necesidades de apoyo psicológico e instrumental, de información y de participación que, de resultar insatisfechas, causan en el cuidador informal estrés, ansiedad, depresión, aislamiento social y disminución de su autoestima. Estos sentimientos comportan una peor calidad del cuidado que presta, afectando la rehabilitación del paciente. El personal de enfermería debe cubrir estas carencias ofreciendo un cuidado individualizado a los cuidadores informales, basado en la comunicación, la escucha activa, la confidencialidad, la gestión de los recursos disponibles, la educación para la salud y la utilización del método científico. Conclusiones: Las carencias relacionadas con los síntomas cognitivos del individuo con lesión cerebral son las que el cuidador percibe con más frecuencia. Estas resultan en el descuido de su propio autocuidado, alterando sustancialmente su calidad de vida. Se han obtenido datos que sugieren que estos hechos podrían dificultar la reconstitución de las capacidades previas del paciente. El personal sanitario debe proveer una atención personalizada, centrada también en el cuidador no remunerado, aumentando sus habilidades y su bienestar., Introdución: As lesións traumáticas constitúen a segunda causa máis común de dano cerebral adquirido. A miúdo, a responsabilidade do coidado de quen padece este tipo de lesión recae nun familiar, frecuentemente unha muller. A atención que presta comporta unha diminución da súa calidade de vida. Obxectivo: Indagar na problemática que resulta do coidado informal e no impacto que ten sobre a persoa con dano cerebral traumático. Analizar a efectividade das intervencións do persoal sanitario. Metodoloxía: Realizáronse 28 buscas avanzadas en 5 bases de datos. A partir dos resultados obtidos leváronse a cabo tres seleccións, obtendo 21 artigos sobre os que se realizou unha exhaustiva revisión bibliográfica. Resultados: Do coidado derívanse novas necesidades de apoio psicolóxico e instrumental, de información e de participación que, de resultar insatisfeitas, orixinan no coidador informal estrés, ansiedade, depresión, illamento social e diminución da súa propia estima. Estes sentimentos comportan unha peor calidade do coidado que presta, afectando á rehabilitación do paciente. O persoal de enfermaría debe cubrir estas carencias ofrecendo un coidado individualizado ós coidadores informais, baseado na comunicación, a escoita activa, a confidencialidade, a xestión dos recursos dispoñibles, a educación para a saúde e a utilización do método científico. Conclusións: As carencias relacionadas cos síntomas cognitivos do individuo con lesión cerebral son as que o coidador percibe con maior frecuencia. Estas resultan no descoido do seu propio autocoidado, alterando substancialmente a súa calidade de vida. Obtivéronse datos que suxiren que estes feitos poderían dificultar a reconstitución das capacidades previas do paciente. O persoal sanitario debe prover unha atención persoalizada, centrada tamén no coidador non remunerado, aumentando as súas habilidades e o seu benestar., Introduction: Traumatic lesions are the second leading cause of acquired brain injury. The responsibility of the atention of those who suffer from brain damage, often falls on one member of the family, usually a woman. The attention that this individual provides imply a decrease in her quality of life. Objective: To investigate the problems that result from informal care and the impact that this has on the person with traumatic brain injury. To analyze the effectiveness of the interventions of the health team. Methodology: 28 advanced searches were performed in 5 databases. Based on the results obtained, three selections were made, obtaining 21 articles on which an exhaustive bibliographic review was carried out. Results: New needs for psychological and instrumental support, information and participation are derived from care, which, if unsatisfied, can cause stress, anxiety, depression, social isolation and lower self-esteem in the informal caregiver. These feelings lead to a worse quality of the atention provided, affecting the patient's rehabilitation. Nurses must cover these deficiencies by offering individualized care to informal caregivers, based on communication, active listening, confidentiality, management of available resources, health education and the use of the scientific method. Conclusions: The deficiencies related to the cognitive symptoms of the individual with brain injury are those that the caregiver perceives most frequently. These result in the neglect of their own self-care, substantially altering their quality of life. The data obtained suggest that these facts could make it difficult to reconstitute the patient's previous capacities. The health team must provide personalized attention, also focused on the informal caregivers, increasing their skills and their well-being.

Objectives The COVID-19 pandemic required a population lockdown during the first wave in March 2020. Evidence has shown a circular relationship between perceived threat and the risk of developing negative mood, which might impact the affect balance of older adults. We aimed to investigate the positive and negative feelings expressed by young–old (60–70 years) and old–old (over 71 years) Spanish adults during the lockdown of the COVID-19 first wave, and the social and psychological variables associated. Methods Cross-sectional study conducted in 528 participants using a questionnaire composed of sociodemographic data and validated scales for resilience (Brief Resilient Coping Scale) and emotions (Scale of Positive and Negative Experience). Results We found a positive balance between positive and negative feelings with no differences between both groups. Regression analysis showed that social network and resilience, but not age, are significant predictors of both greater positive feelings and lower negative feelings. Conclusions Our results evidence the relevance of promoting targeted support psychological and social measures that effectively help older adults to cope with such a difficult scenario as the current pandemic. Clinical implications Health-care providers must develop targeted care strategies aimed at providing emotional support for older adults from a holistic perspective

Research on personality variables and consumption of health services in actively employed people or retirees has been extensive, but the group of pre-retirees has hardly been studied. This work attempts to determine the mental health and use of health resources of the three groups, hypothesizing that, as the group of pre-retirees does not receive the social stigma of work exclusion, it will present better mental health. A sample of 1332 Spanish participants aged between 51 and 69 years was randomly chosen, and various personality tests were applied, and consumption of healthcare resources was determined. Pairwise analysis of the three work situations using binary logistic regressions showed that pre-retirees present better mental health, although there were no differences in the consumption of healthcare resources. The implications of this study for the creation of health promotion policies targeting older people, depending specifically on their employment status, are discussed

Family caregivers of persons with dementia often experience a negative impact on their health. More studies based on nursing theories are needed to improve the provision of care

Expenditure on healthcare and services can be a serious problem for public health. Personality variables should be included as indicators to be considered when studying the consumption of health resources and their planning. This study aims to identify the psychological and psychosocial variables that identify people who can be considered high consumers of health resources versus those who barely consume such resources. The sample was made up of a total of 1124 subjects; one half were men, and one half were women, all of legal age and residents in Spain. A battery of tests was created that included a questionnaire of sociodemographic variables and of healthcare consumption, as well as several psychological variables (Zimbardo Time Paradox Inventory, Multidimensional Locus of Control Scale, Psychological Reactance Scale, Coping Responses Inventory, self-efficacy scale applied to health, and the Symptom Checklist-90-R). The following variables of the model were significant predictors (p ≤ 0.05): a negative past, a fatalistic present, psychological cognitive reactance, behavioral coping, health self-efficacy, and the level of somatization. Data from the statistical analyses show how to create a psychological profile of people who are high consumers of healthcare resources that will allow for the creation of intervention programs in this regard.

Background: Dementia is a brain syndrome that affects a growing number of persons worldwide and generates a strong and progressive demand for care from a family caregiver, usually females. Objective: We aimed to describe the care provided by family caregivers of persons with dementia as well as the impact on their health and its interrelation with gender Patient involvement. This study was carried out in collaboration with the 13 associations of family caregivers of persons with dementia that are part of a Regional Federation. This partnership worked towards bettering patient care and proposing improvements to the public health system. Methods: A multi-institutional cross-sectional study. A total of 462 primary family caregivers of persons with dementia from north-west Spain were included. Data were collected between January and April 2019 with an anonymous self-administered validated questionnaire (ICUB-97) based on Virginia Henderson’s nursing care model. Results: The most affected needs in family caregivers are those related to “recreational activities”, “communication” and “rest and sleep”. Statistically significant differences between male and female participants’ pattern of care and health-related impacts were found, especially in issues related to work and family reconciliation. Discussion: Care plans should be developed taking gender perspective into account. From a nurse model point of view, more research is necessary to reduce health disparities. This study provides an assessment of gender differences in care and the impact on caregivers’ health. Practical value: Regarding the specific health conditions of female caregivers and from a holistic point of view, these findings could provide novel and interesting data that might help to implement gender perspective in nursing care plans, generally invisible in routine clinical practice

[Resumen] El uso de la asistencia sanitaria no sólo está determinado por la complejidad del proceso de salud o por el estado funcional del paciente, sino también por otras variables, entre ellas, las psicológicas. Este trabajo tuvo por objetivo estudiar la incidencia de características psicológicas específicas, valorar en qué medida éstas se relacionan con la integración al mundo laboral y estudiar qué variables psicológicas y psicosociales nos permiten identificar a las personas que pueden ser consideradas grandes consumidoras de recursos sanitarios. Se realizaron tres estudios observacionales y correlacionales de tipo transversal sobre muestras diferenciadas (n1=438; n2=1332; n3=1124) constituidas por personas adultas residentes en Galicia. Los resultados señalan que sería posible establecer un perfil diferenciador en el que variables vinculadas a la autoeficacia y una visión optimista del mundo identifiquen a personas con menor probabilidad de consumo de recursos sanitarios. Asimismo, implicarían perfiles psicológicos diferenciales las categorías de trabajador activo, prejubilado o jubilado., [Resumo]O uso da asistencia sanitaria non só está determinado pola complexidade do proceso de saúde ou polo estado funcional do paciente, senón tamén por outras variables, entre elas, as psicolóxicas. Este traballo tivo por obxectivo estudar a incidencia de características psicolóxicas específicas, valorar en que medida estas relaciónanse coa integración ao mundo laboral e estudar que variables psicolóxicas e psicosociais permítennos identificar as persoas que poden ser consideradas grandes consumidoras de recursos sanitarios. Realizáronse tres estudos observacionales e correlacionales de tipo transversal sobre mostras diferenciadas (n1=438; n2=1332; n3=1124) constituídas por persoas adultas residentes en Galicia. Os resultados sinalan que sería posible establecer un perfil diferenciador no que variables vinculadas á autoeficacia e unha visión optimista do mundo identifiquen a persoas con menor probabilidade de consumo de recursos sanitarios. Así mesmo, implicarían perfís psicolóxicos diferenciais as categorías de traballador activo, prexubilado ou xubilado., [Abstract]The use of health care is not only determined by the complexity of the health process or by the functional state of the patient, but also by other variables, including psychological ones. The aim of this work was to study the incidence of specific psychological characteristics, to assess to what extent these are related to integration into the world of work and to study which psychological and psychosocial variables allow us to identify people who can be considered high consumers of health care resources. Three cross sectional observational and correlational studies were carried out on different samples (n1=438; n2=1332; n3=1124) made up of adults living in Galicia. The results indicate that it would be possible to establish a differentiating profile in which variables linked to self efficacy and an optimistic view of the world identify people with a lower probability of consuming health resources. Likewise, the categories of active worker, pre retired or retired would imply differential psychological profiles.

[Abstract]: Expenditure on healthcare and services can be a serious problem for public health. Personality variables should be included as indicators to be considered when studying the consumption of health resources and their planning. This study aims to identify the psychological and psychosocial variables that identify people who can be considered high consumers of health resources versus those who barely consume such resources. The sample was made up of a total of 1124 subjects; one half were men, and one half were women, all of legal age and residents in Spain. A battery of tests was created that included a questionnaire of sociodemographic variables and of healthcare consumption, as well as several psychological variables (Zimbardo Time Paradox Inventory, Multidimensional Locus of Control Scale, Psychological Reactance Scale, Coping Responses Inventory, self-efficacy scale applied to health, and the Symptom Checklist-90-R). The following variables of the model were significant predictors (p _ 0.05): a negative past, a fatalistic present, psychological cognitive reactance, behavioral coping, health self-efficacy, and the level of somatization. Data from the statistical analyses show how to create a psychological profile of people who are high consumers of healthcare resources that will allow for the creation of intervention programs in this regard.

[Abstract] Research on personality variables and consumption of health services in actively employed people or retirees has been extensive, but the group of pre-retirees has hardly been studied. This work attempts to determine the mental health and use of health resources of the three groups, hypothesizing that, as the group of pre-retirees does not receive the social stigma of work exclusion, it will present better mental health. A sample of 1332 Spanish participants aged between 51 and 69 years was randomly chosen, and various personality tests were applied, and consumption of healthcare resources was determined. Pairwise analysis of the three work situations using binary logistic regressions showed that pre-retirees present better mental health, although there were no differences in the consumption of healthcare resources. The implications of this study for the creation of health promotion policies targeting older people, depending specifically on their employment status, are discussed.