ORCID Profile
0000-0002-8039-3427
Current Organisations
Escuela Andaluza de Salud Pública
,
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública
,
Asociación Mujeres Politólogas
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Publications
Healthcare interventions for depression in low socioeconomic status populations: A systematic review and meta-analysis
Publisher: Elsevier BV
Date: 06-2015
DOI: 10.1016/J.CPR.2015.03.001
Abstract: The prevalence and impact of depressive disorders in developed countries are associated with certain population characteristics, including socioeconomic status. The aim of this systematic review and meta-analysis was to identify, characterize and analyze the short- and long-term effectiveness of healthcare interventions for depressive disorders in low socioeconomic status populations. The main biomedical databases were searched and fifteen articles assessing seventeen interventions were included in the review. Most interventions were implemented in the US (n=11) and culturally adapted (n=11). We conducted two meta-analyses for assessing both the short- (n=11) and long-term effectiveness (n=12) of interventions. There was a statistically significant reduction in overall depressive symptoms (-0.58, 95% CI [-0.74, -0.41]) at short-term (up to three months after the intervention), especially for combined and psychotherapeutic interventions. The overall effect slightly decreased at long-term (-0.42, 95% CI [-0.63, -0.21]). Those interventions including culturally specific training for providers and booster sessions seemed to be more effective in reducing depressive disorders at short and long term, respectively. In conclusion, healthcare interventions are effective in decreasing clinically significant depressive disorders in low socioeconomic status populations. Future interventions should take into account the key characteristics identified in this review.
Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis
Publisher: Elsevier BV
Date: 12-2020
Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review
Publisher: Cold Spring Harbor Laboratory
Date: 06-04-2020
DOI: 10.1101/2020.04.02.20048892
Abstract: To examine the impact of providing healthcare during or after health emergencies caused by viral epidemic outbreaks on healthcare workers′(HCWs) mental health, and to assess the available evidence base regarding interventions to reduce such impact. Systematic rapid review and meta-analysis. MEDLINE, Embase, and PsycINFO, searched up to 23 March 2020. We selected observational and experimental studies examining the impact on mental health of epidemic outbreaks on HCWs. One reviewer screened titles and abstracts, and two reviewers independently reviewed full texts. We extracted study characteristics, symptoms, prevalence of mental health problems, risk factors, mental health interventions, and its impact. We assessed risk of bias for each in idual study and used GRADE to ascertain the certainty of the evidence. We conducted a narrative and tabulated synthesis of the results. We pooled data using random-effects meta-analyses to estimate the prevalence of specific mental health problems. We included 61 studies (56 examining impact on mental health and five about interventions to reduce such impact). Most were conducted in Asia (59%), in the hospital setting (79%), and examined the impact of the SARS epidemic (69%). The pooled prevalence was higher for anxiety (45%, 95% CI 21 to 69% 6 studies, 3,373 participants), followed by depression (38%, 95% CI 15 to 60% 7 studies, 3,636 participants), acute stress disorder (31%, 95% CI 0 to 82%, 3 studies, 2,587 participants), burnout (29%, 95% CI 25 to 32% 3 studies 1,168 participants), and post-traumatic stress disorder (19%, 95% CI 11 to 26%, 10 studies, 3,121 participants). Based on 37 studies, we identified factors associated with the likelihood of developing those problems, including sociodemographic (younger age and female gender), social (lack of social support, social rejection or isolation, stigmatization), and occupational (working in a high risk environment (frontline staff), specific occupational roles (e.g., nurse), and lower levels of specialised training, preparedness and job experience) factors. Five studies reported interventions for frontline HCW, two of which were educational and aimed to prevent mental health problems by increasing HCWs′ resilience. These interventions increased confidence in support and training, pandemic self-efficacy, and interpersonal problems solving (very low certainty). One multifaceted intervention implemented training and organisational changes) targeted at hospital nurses during the SARS epidemic, reporting improvements in anxiety, depression, and sleep quality (very low certainty). The two remaining interventions, which were multifaceted and based on psychotherapy provision, did not assess their impact. The prevalence of anxiety, depression, acute and post-traumatic stress disorder, and burnout, was high both during and after the outbreaks. These problems not only have a long-lasting effect on the mental health of HCWs, but also hinder the urgent response to the current COVID-19 pandemic, by jeopardising attention and decision-making. Governments and healthcare authorities should take urgent actions to protect the mental health of HCWs. In light of the limited evidence regarding the impact of interventions to tackle mental health problems in HCWs, the risk factors identified in this study, more so when they are modifiable, represent important targets for future interventions. 1: Previous studies showed that healthcare workers involved providing frontline care during viral epidemic outbreaks are at high risk of developing mental health problems. Given the current COVID-19 pandemic, there is an urgent need to synthesize the evidence regarding the impact of viral epidemic outbreaks on mental health of healthcare workers. 2: This timely systematic rapid review offers for the first time pooled estimations of the prevalence of the most common mental health problems experienced by HCWs during and after viral epidemic outbreaks, namely anxiety (45%), depression (38%), and acute stress disorder (31%), among others. Our study also identifies a broad number of factors associated with these conditions, including sociodemographic factors such as younger age and female gender, social factors such as lack of social support, social rejection or isolation, stigmatization, and occupational factors such as working in a high risk environment, specific occupational roles, and having lower levels of specialised training, preparedness and job experience. Our study shows that, although educational and multifaceted interventions might mitigate the development of mental health problems, the certainty on the evidence is very low - therefore indicating that further high quality research is urgently needed to inform evidence-based policies for viral pandemics.
Related Organisations
Fundación Pública Andaluza Para La Investigación Biosanitaria Andalucía Oriental
Location: Spain
Centro De Investigación Biomédica En Red De Epidemiología Y Salud Pública
Location: Spain
Related Funding Activities
No related grants have been discovered for Guadalupe Pastor Moreno.