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Background: The e-Learning with flipped classroom approach educational program is an alternative to online learning (e-Learning) and face-to-face learning for addressing the challenges related to long-distance skill training. Methods: Consisting of weekly live-time virtual sessions with expert physicians, available resources including updated guidelines, review articles, and blog interactions between colleagues for discussing the clinical cases to improve learning techniques. The availability of all the content (recorded lectures and bibliography) at any time for review is an important aspect for easy learning. This multimodal approach was directed to medical students working in rural communities to get the necessary skills for preventing, diagnosing, treating, and improving the quality of care in non-communicable chronic diseases (NCCD). In addition, this model includes a pre and post-course evaluation, a quality of care test, and a dropout and satisfaction survey. The students who obtain the approving grade at the end of the course get a certificate with medical endorsement.

COVID-19 frontline healthcare workers (FHCW) are struggling to cope with challenges that threaten their wellbeing. We examine the frequency and predictors of the most frequent mental health problems (MHP) among FHCW during the first COVID-19 peak in Mexico, one of the most severely affected countries in terms of FHCW’s COVID-19 mortality. A cross-sectional survey was conducted between May 8 and August 18, 2020. A total of 47.5% of the sample (n = 2218) were FHCW. The most frequent MHP were insomnia, depression, posttraumatic stress symptoms, and health anxiety/somatization (whole sample: 45.7, 37.4, 33.9, and 21.3%; FHCW: 52.4, 43.4, 40.3 and 26.1, respectively). As compared to during the initial COVID-19 phase, depression and health anxiety/somatization symptoms as well as experiences of grieving due to COVID-19, personal COVID-19 status, and having relatives and close friends with COVID-19 were more frequent during the COVID-19 peak. Obesity, domestic violence, personal COVID-19 status, and grieving because of COVID-19 were included in regression models for main FHCW’s MHP during the COVID-19 peak. In conclusion, measures to decrease other country-level epidemics contributing to the likelihood of COVID-19 complications (obesity) and MHP (domestic violence) as well as FHCW´s probability of COVID-19 infection could safeguard not only their physical but also mental health.

Background: The Physician Well-Being Index (PWBI) is a brief, valid, reliable self-assessment instrument to identify health professionals’ distress and those in need of an intervention. Objective: to evaluate the construct, predictive validity (of depression, suicidal ideation, insomnia, and generalized anxiety), and internal consistency of the 7-item Spanish version of the PWBI (PWBI-S). Methods: out of a national population of approximately 1 million Mexican healthcare professionals, a sample of 3506 subjects (42.0% physicians, 28.7% nurses and 29.3% psychologists) completed an online survey between 17 April and 7 May 2020, at the time of the COVID-19 case cluster transmission scenario in Mexico. Results: In the three sub-samples, PWBI-S’s Confirmatory factor analyses (adding residual covariances) exhibited adequate goodness of fit indices for the PWBS original unidimensional model. Overall Cronbach’s alphas were 0.89 for physicians, 0.90 for nurses, and 0.86 for psychologists. Univariate logistic regression models showed that a cutoff point of 3 on the total score of the PWBI-S was generally related to the presence of depression, suicidal ideation, and insomnia, but not with generalized anxiety among nurses and psychologists. When trying with a cutoff point of 3, a relationship with GA was shown in psychologists, but not in nurses. Conclusions: our findings suggest that PWBI-S is a valid, reliable measure for clinical and research purposes in the field.

Introduction. Since mental health disorders are an emerging problem in medical residents, its detection and attention must be a priority. Objetive. To compare the frequency of psychopathology in residents according to sociodemographic and clinical characteristics. Method. We conducted a cross-sectional study evaluating the presence of psychopathology, as well as sociodemographic and clinical characteristics in 644 residents through online questionnaires. Results. Among participants, 55.7% reported a psychiatric disorder at some point and 29.2% a current one; only 41.5% were under treatment. Additionally, 8.1% had attempted suicide, of which 32.4% attempted it during residency. We found that 6.5% of women and 3.3% of men presented “risk of psychopathology,” with a higher percentage of men presenting “severe psychopathology.” Individuals with “risk of psychopathology” presented significantly higher scores on all of the questionnaires, compared to those with “absence of psychopathology.” Discussion and conclusion. Residents with occupational stress also presented higher risks of psychopathology, suicide, and substance use. Being under psychiatric treatment significantly improved the scores on the different scales. Because residency is a period that may increase the probability of suffering psychopathology, interventions should be aimed at reducing occupational stress and bringing specialized care.

Objective: The mental health problems and perceived needs of healthcare workers involved with coronavirus disease (COVID-19) may vary due to individual and contextual characteristics. The objective of this study was to evaluate healthcare workers’ mental health problems during the common COVID-19 exposure scenario in Mexico, comparing those on the frontline with other healthcare workers according to gender and profession, determining the main risk factors for the most frequent mental health problems. Methods: A cross-sectional online study was conducted with a non-probabilistic sample of 5,938 Mexican healthcare workers who completed brief screening measures of mental health problems and ad hoc questions about sociodemographic professional characteristics, conditions related to increased risk of COVID-19 infection, life stressors during the COVID-19 emergency, and perceived need to cope with COVID-19. Results: The identified mental health problems were insomnia, depression, and posttraumatic stress disorder (PTSD), all of which were more frequent in frontline healthcare workers (52.1, 37.7, and 37.5%, respectively) and women (47.1, 33.0 %, and 16.3%, respectively). A lack of rest time was the main risk factor for insomnia (OR = 3.1, 95%CI 2.6-3.7, p ≤ 0.0001). Mourning the death of friends or loved ones due to COVID-19 was the main risk factor for depression (OR = 2.2, 95%CI 1.8-2.7, p ≤ 0.0001), and personal COVID-19 status was the main risk factor for PTSD (OR = 2.2, 95%CI 1.7-2.9, p ≤ 0.0001). Conclusion: The most frequent mental health problems during the common exposure scenario for COVID-19 in Mexico included the short-term psychological consequences of intense adversity. A comprehensive strategy for preventing mental health problems should focus on individuals with cumulative vulnerability and specific risk factors.

En Mexico se crearon cinco clinicas virtuales de salud mental para los trabajadores de la salud como parte de la respuesta nacional de salud mental ante la pandemia por COVID-19. La clinica de desgaste, estres postraumatico y fatiga por compasion es una de ellas. Objetivo Describir las caracteristicas sociodemograficas y psicologicas basales de los trabajadores de la salud que asistieron a las sesiones virtuales de atencion plena, que constituyeron una de las estrategias de atencion en la clinica. Metodo Estudio transversal, parte de un proyecto nacional y longitudinal. Los participantes contestaron un cuestionario digital con preguntas sociodemograficas y sobre la situacion actual del COVID-19, el Indice Extendido de Bienestar Medico y la escala TOP-8 de estres postraumatico. Resultados De los 507 trabajadores de la salud que participaron, 70.02% presentaron riesgo de desgaste segun el Indice de Bienestar Extendido, y 57.31, 7.91 y 2.77% de riesgo leve, moderado y grave en el TOP-8, respectivamente. Las mujeres, los habitantes de la zona metropolitana o del centro del pais, aquellos con diagnostico de COVID-19 y los expuestos a personas con dicho diagnostico fueron los mas afectados. Discusion y conclusion Los participantes de las sesiones de atencion plena presentaron altas frecuencias de sintomas de estres postraumatico y desgaste (burnout). Como las trabajadoras de zonas urbanizadas podrian correr un riesgo especial, deberia darseles un seguimiento especial, en particular a aquellas en contacto directo con personas positivas al COVID-19. La participacion temprana en estrategias de salud mental podria amortiguar los efectos inmediatos y de largo plazo de la pandemia