Escala de ansiedad generalizada GAD-7 en profesionales médicos colombianos durante pandemia de COVID-19: validez de constructo y confiabilidad

Introduction: The detection of anxiety symptoms among health workers who care for patients infected with COVID-19 is a current priority. Fast and valid instruments are required for this population group. The objective is to establish the construct validity and reliability of the Generalised Anxiety...

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Autores: Camargo, Loida, Herrera-Pino, Jorge Alfredo, Shelach , Salomon, Soto-Añari, Marcio, Porto, María F., ALONSO, MONICA, González, Miguel, Contreras, Oscar, Caldichoury, Nicole, Ramos-Henderson, Miguel, GARGIULO, Pascual, López, Norman
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2021
País:Colombia
Institución:Corporación Universidad de la Costa
Repositorio:Repositorio REDICUC
Idioma:español
OAI Identifier:oai:repositorio.cuc.edu.co:11323/8897
Acceso en línea:https://hdl.handle.net/11323/8897
https://doi.org/10.1016/j.rcp.2021.06.003
https://repositorio.cuc.edu.co/
Access Level:acceso abierto
Palabra clave:GAD-7
Anxiety
Psychometrics
COVID-19
Health workers
Ansiedad
Psicometría
Personal sanitario
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repository_id_str
dc.title.none.fl_str_mv Escala de ansiedad generalizada GAD-7 en profesionales médicos colombianos durante pandemia de COVID-19: validez de constructo y confiabilidad
GAD-7 Generalised Anxiety Disorder scale in Colombian medical professionals during the COVID-19 pandemic: construct validity and reliability
title Escala de ansiedad generalizada GAD-7 en profesionales médicos colombianos durante pandemia de COVID-19: validez de constructo y confiabilidad
spellingShingle Escala de ansiedad generalizada GAD-7 en profesionales médicos colombianos durante pandemia de COVID-19: validez de constructo y confiabilidad
Camargo, Loida
GAD-7
Anxiety
Psychometrics
COVID-19
Health workers
Ansiedad
Psicometría
Personal sanitario
title_short Escala de ansiedad generalizada GAD-7 en profesionales médicos colombianos durante pandemia de COVID-19: validez de constructo y confiabilidad
title_full Escala de ansiedad generalizada GAD-7 en profesionales médicos colombianos durante pandemia de COVID-19: validez de constructo y confiabilidad
title_fullStr Escala de ansiedad generalizada GAD-7 en profesionales médicos colombianos durante pandemia de COVID-19: validez de constructo y confiabilidad
title_full_unstemmed Escala de ansiedad generalizada GAD-7 en profesionales médicos colombianos durante pandemia de COVID-19: validez de constructo y confiabilidad
title_sort Escala de ansiedad generalizada GAD-7 en profesionales médicos colombianos durante pandemia de COVID-19: validez de constructo y confiabilidad
dc.creator.none.fl_str_mv Camargo, Loida
Herrera-Pino, Jorge Alfredo
Shelach , Salomon
Soto-Añari, Marcio
Porto, María F.
ALONSO, MONICA
González, Miguel
Contreras, Oscar
Caldichoury, Nicole
Ramos-Henderson, Miguel
GARGIULO, Pascual
López, Norman
author Camargo, Loida
author_facet Camargo, Loida
Herrera-Pino, Jorge Alfredo
Shelach , Salomon
Soto-Añari, Marcio
Porto, María F.
ALONSO, MONICA
González, Miguel
Contreras, Oscar
Caldichoury, Nicole
Ramos-Henderson, Miguel
GARGIULO, Pascual
López, Norman
author_role author
author2 Herrera-Pino, Jorge Alfredo
Shelach , Salomon
Soto-Añari, Marcio
Porto, María F.
ALONSO, MONICA
González, Miguel
Contreras, Oscar
Caldichoury, Nicole
Ramos-Henderson, Miguel
GARGIULO, Pascual
López, Norman
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv GAD-7
Anxiety
Psychometrics
COVID-19
Health workers
Ansiedad
Psicometría
Personal sanitario
topic GAD-7
Anxiety
Psychometrics
COVID-19
Health workers
Ansiedad
Psicometría
Personal sanitario
description Introduction: The detection of anxiety symptoms among health workers who care for patients infected with COVID-19 is a current priority. Fast and valid instruments are required for this population group. The objective is to establish the construct validity and reliability of the Generalised Anxiety Disorder (GAD-7) scale in Colombian doctors during the COVID-19 lockdown. Methods: E-health study, in which cross-sectional data were collected online (n= 1,030) from 610 COVID doctors and 420 non-COVID doctors, during the Colombian lockdown, between 20 April and 10 August 2020. Each subject was contacted, and they confirmed their participation, identity and professional role. Results: A single factor factorial structure was found, made up of the 7 items of the instrument, which managed to explain 70% of the variance. The goodness of fit indices (RMSEA = 0.080; CFI = 0.995; SRMR = 0.053; p < 0.001) showed an “acceptable” unidimensionality and adequate factor loadings in each item of the GAD-7, >0.070. Finally, the internal consistency of the instrument was good, with a Cronbach’s alpha of 0.920 (95%IC, 8.80-9.71). Conclusions: The GAD-7 is an instrument that presents adequate indicators of validity and reliability. It is an excellent tool that is reliable and easy and fast to use for the detection of generalised anxiety symptoms in medical personnel caring (or not) for patients infected with COVID-19.
publishDate 2021
dc.date.none.fl_str_mv 2021-11-23T19:17:11Z
2021-11-23T19:17:11Z
2021
dc.type.none.fl_str_mv Artículo de revista
http://purl.org/coar/resource_type/c_6501
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dc.identifier.none.fl_str_mv 0034-7450
https://hdl.handle.net/11323/8897
https://doi.org/10.1016/j.rcp.2021.06.003
Corporación Universidad de la Costa
REDICUC - Repositorio CUC
https://repositorio.cuc.edu.co/
identifier_str_mv 0034-7450
Corporación Universidad de la Costa
REDICUC - Repositorio CUC
url https://hdl.handle.net/11323/8897
https://doi.org/10.1016/j.rcp.2021.06.003
https://repositorio.cuc.edu.co/
dc.language.none.fl_str_mv spa
language spa
dc.relation.none.fl_str_mv 1. Asociación Americana de Psiquiatría. Manual diagnóstico y estadístico de los trastornos mentales: DSM-5. APA; 2014.
2. Phillips KA, Friedman MJ, Stein DJ, Craske M. Special DSM-V issues on anxiety, obsessive-compulsive spectrum, posttraumatic, and dissociative disorders. Depress Anxiety. 2010;27:91–2.
3. Danet Danet A. Psychological impact of COVID-19 pandemic in Western frontline healthcare professionals. A systematic review. Med Clin (Barc). 2021.
4. Alonso J, Vilagut G, Mortier P, Ferrer M, Alayo I, Aragón-Pena˜ A, et al. Mental health impact of the first wave of COVID-19 pandemic on Spanish healthcare workers: A large cross-sectional survey. Rev Psiquiatria Salud Mental. 2021.
5. Zheng R, Zhou Y, Qiu M, Yan Y, Yue J, Yu L, et al. Prevalence and associated factors of depression, anxiety, and stress among Hubei pediatric nurses during COVID-19 pandemic. Comprehens Psychiatry. 2021:104.
6. Liu CY, Yang YZ, Zhang XM, Xu X, Dou QL, Zhang W, et al. The prevalence and influencing factors in anxiety in medical workers fighting COVID-19 in China: A cross-sectional survey. Epidemiol Infect. 2020:148.
7. Feinstein RE, Kotara S, Jones B, Shanor D, Nemeroff CB. A health care workers mental health crisis line in the age of COVID-19. Depress Anxiety. 2020;37:822–6.
8. da Silva FCT, Neto MLR. Psychological effects caused by the COVID-19 pandemic in health professionals: A systematic review with meta-analysis. Prog Neuro-Psychopharmacol Biol Psychiatry. 2021:104.
9. Thombs BD, Saadat N, Riehm KE, Karter JM, Vaswani A, Andrews BK, et al. Consistency and sources of divergence in recommendations on screening with questionnaires for presently experienced health problems or symptoms: A comparison of recommendations from the Canadian Task Force on Preventive Health Care UK National Screening Committee, and US Preventive Services Task Force. BMC Medicine. 2017;15:150.
10. Cassiani-Miranda CA, Cuadros-Cruz AK, Torres-Pinzón H, Scoppetta O, Pinzón-Tarrazona JH, López-Fuentes WY, et al. Validity of the Patient Health Questionnaire-9 (PHQ-9) for depression screening in adult primary care users in Bucaramanga. Colombia. Rev Colomb Psiquiatr. 2021;50:11–21.
11. Scoppetta O, Cassiani-Miranda CA, Arocha-Díaz KN, Cabanzo-Arenas DF, Campo-Arias A. Validity of the patient health questionnaire-2 (PHQ-2) for the detection of depression in primary care in Colombia. J Affect Disord. 2021;278:576–82.
12. Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: The GAD-7. Arch Intern Med. 2006;166:1092–7.
13. Ahn J-K, Kim Y, Choi K-H. The psychometric properties and clinical utility of the Korean version of GAD-7 and GAD-2. Front Psychiatry. 2019;10:127.
14. Gong Y, Zhou H, Zhang Y, Zhu X, Wang X, Shen B, et al. Validation of the 7-item Generalized Anxiety Disorder scale (GAD-7) as a screening tool for anxiety among pregnant Chinese women. J Affect Disord. 2021;282:98–103.
15. Hinz A, Klein AM, Brähler E, Glaesmer H, Luck T, Riedel-Heller SG, et al. Psychometric evaluation of the Generalized Anxiety Disorder Screener GAD-7, based on a large German general population sample. J Affect Disord. 2017;210:338–44.
16. Monterrosa-Castro A, Redondo-Mendoza V, Mercado-Lara M. Psychosocial factors associated with symptoms of generalized anxiety disorder in general practitioners during the COVID-19 pandemic. J Invest Med. 2020;68:1228–34.
17. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606–13.
18. García-Campayo J, Zamorano E, Ruiz MA, Pardo A, Pérez-Páramo M, López-Gómez V, et al. Cultural adaptation into Spanish of the generalized anxiety disorder-7 (GAD-7) scale as a screening tool. Health Qual Life Outcomes. 2010:8.
19. Masuyama A, Shinkawa H, Kubo T. Validation and psychometric properties of the Japanese version Fear of COVID-19 Scale among adolescents. 2020. Disponible en: https://psyarxiv.com/jkmut/. Consultado 25 Mar 2021.
20. Munoz-Navarro ˜ R, Cano-Vindel A, Moriana JA, Medrano LA, Ruiz-Rodríguez P, Agüero-Gento L, et al. Screening for generalized anxiety disorder in Spanish primary care centers with the GAD-7. Psychiatr Res. 2017;256:312–7.
21. Seo JG, Park SP. Validation of the Generalized Anxiety Disorder-7 (GAD-7) and GAD-2 in patients with migraine. J Headache Pain. 2015;16:1–7.
22. Zhong QY, Gelaye B, Zaslavsky AM, Fann JR, Rondon MB, Sánchez SE, et al. Diagnostic validity of the generalized anxiety disorder-7 (GAD-7) among pregnant women. PLoS ONE. 2015;10:125096.
23. Jordan P, Shedden-Mora MC, Löwe B. Psychometric analysis of the Generalized Anxiety Disorder scale (GAD-7) in primary care using modern item response theory. PLoS ONE. 2017;12(8.).
24. Esser P, Hartung TJ, Friedrich M, Johansen C, Wittchen HU, Faller H. The Generalized Anxiety Disorder Screener (GAD-7) and the anxiety module of the Hospital and Depression Scale (HADS-A) as screening tools for generalized anxiety disorder among cancer patients. Psycho-Oncol. 2018;27:1509–16.
25. Teo WZY, Soo YE, Yip C, Lizhen O, Chun-Tsu L. The psychological impact of COVID-19 on ‘hidden’ frontline healthcare workers. Int J Soc Psychiatry. 2020. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32779498/.
26. Osman A, Wong JL, Bagge CL, Freedenthal S, Gutierrez PM, Lozano G. The Depression Anxiety Stress Scales-21 (DASS-21): further examination of dimensions, scale reliability, and correlates. J Clin Psychol. 2012;68:1322–38.
27. Ma Y, Rosenheck R, He H. Psychological stress among health care professionals during the 2019 novel coronavirus disease Outbreak: Cases from online consulting customers. Intens Crit Care Nurs. 2020;61:102905.
dc.rights.none.fl_str_mv CC0 1.0 Universal
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dc.publisher.none.fl_str_mv Corporación Universidad de la Costa
publisher.none.fl_str_mv Corporación Universidad de la Costa
dc.source.none.fl_str_mv Revista Colombiana de Psiquiatría
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8249708/
reponame:Repositorio REDICUC
instname:Corporación Universidad de la Costa
instacron:Corporación Universidad de la Costa
instname_str Corporación Universidad de la Costa
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reponame_str Repositorio REDICUC
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spelling Escala de ansiedad generalizada GAD-7 en profesionales médicos colombianos durante pandemia de COVID-19: validez de constructo y confiabilidadGAD-7 Generalised Anxiety Disorder scale in Colombian medical professionals during the COVID-19 pandemic: construct validity and reliabilityCamargo, LoidaHerrera-Pino, Jorge AlfredoShelach , SalomonSoto-Añari, MarcioPorto, María F.ALONSO, MONICAGonzález, MiguelContreras, OscarCaldichoury, NicoleRamos-Henderson, MiguelGARGIULO, PascualLópez, NormanGAD-7AnxietyPsychometricsCOVID-19Health workersAnsiedadPsicometríaPersonal sanitarioIntroduction: The detection of anxiety symptoms among health workers who care for patients infected with COVID-19 is a current priority. Fast and valid instruments are required for this population group. The objective is to establish the construct validity and reliability of the Generalised Anxiety Disorder (GAD-7) scale in Colombian doctors during the COVID-19 lockdown. Methods: E-health study, in which cross-sectional data were collected online (n= 1,030) from 610 COVID doctors and 420 non-COVID doctors, during the Colombian lockdown, between 20 April and 10 August 2020. Each subject was contacted, and they confirmed their participation, identity and professional role. Results: A single factor factorial structure was found, made up of the 7 items of the instrument, which managed to explain 70% of the variance. The goodness of fit indices (RMSEA = 0.080; CFI = 0.995; SRMR = 0.053; p < 0.001) showed an “acceptable” unidimensionality and adequate factor loadings in each item of the GAD-7, >0.070. Finally, the internal consistency of the instrument was good, with a Cronbach’s alpha of 0.920 (95%IC, 8.80-9.71). Conclusions: The GAD-7 is an instrument that presents adequate indicators of validity and reliability. It is an excellent tool that is reliable and easy and fast to use for the detection of generalised anxiety symptoms in medical personnel caring (or not) for patients infected with COVID-19.Introducción: La detección de síntomas de ansiedad entre el personal sanitario que atiende a pacientes contagiados de COVID-19 es una prioridad actual. Se requieren instrumentos rápidos y válidos para esta población. El objetivo es establecer la validez de constructo y la confiabilidad de la Escala de Ansiedad Generalizada (GAD-7) en médicos colombianos durante la cuarentena por la COVID-19. Métodos: Estudio eSalud, en el que se recopilaron datos transversales en línea (n= 1.030) de 610 médicos de COVID y 420 no de COVID durante la cuarentena colombiana, entre el 20 de abril y el 10 de agosto de 2020. Se contactó con cada sujeto, que confirmó participación, identidad y función profesional. Resultados: Se encontró una estructura factorial de 1 solo factor, conformado por los 7 ítems del instrumento, que logró explicar el 70% de la varianza. Los índices de bondad de ajuste (RMSEA = 0,080; CFI = 0,995; SRMR = 0,053; p < 0,001) mostraron una unidimensionalidad «aceptable» y adecuadas cargas factoriales en cada ítem del GAD-7, > 0,07. Por último, la consistencia interna del instrumento fue buena, con alfa de Cronbach= 0,920 (IC95%, 8,80-9,71). Conclusiones: El GAD-7 es un instrumento que presenta indicadores adecuados de validez y confiabilidad. Es un excelente instrumento, confiable, fácil y rápido de usar para la detección de los síntomas de ansiedad generalizada en personal médico, atienda o no a pacientes contagiados de COVID-19.Camargo, Loida-will be generated-orcid-0000-0003-0056-6832-600Herrera-Pino, Jorge Alfredo-will be generated-orcid-0000-0002-2690-4791-600Shelach, Salomon-will be generated-orcid-0000-0003-0314-423X-600Soto-Añari, Marcio-will be generated-orcid-0000-0002-9121-3284-600Porto, María F.-will be generated-orcid-0000-0002-3927-5808-600ALONSO, MONICA-will be generated-orcid-0000-0001-9006-8196-600González, MiguelContreras, OscarCaldichoury, NicoleRamos-Henderson, Miguel-will be generated-orcid-0000-0003-1045-6872-600GARGIULO, Pascual-will be generated-orcid-0000-0003-2962-4346-600López, NormanCorporación Universidad de la Costa2021-11-23T19:17:11Z2021-11-23T19:17:11Z2021Artículo de revistahttp://purl.org/coar/resource_type/c_6501Textinfo:eu-repo/semantics/articlehttp://purl.org/redcol/resource_type/ARTinfo:eu-repo/semantics/acceptedVersionhttp://purl.org/coar/version/c_ab4af688f83e57aaapplication/pdfapplication/pdf0034-7450https://hdl.handle.net/11323/8897https://doi.org/10.1016/j.rcp.2021.06.003Corporación Universidad de la CostaREDICUC - Repositorio CUChttps://repositorio.cuc.edu.co/Revista Colombiana de Psiquiatríahttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8249708/reponame:Repositorio REDICUCinstname:Corporación Universidad de la Costainstacron:Corporación Universidad de la Costaspa1. Asociación Americana de Psiquiatría. Manual diagnóstico y estadístico de los trastornos mentales: DSM-5. APA; 2014.2. Phillips KA, Friedman MJ, Stein DJ, Craske M. Special DSM-V issues on anxiety, obsessive-compulsive spectrum, posttraumatic, and dissociative disorders. Depress Anxiety. 2010;27:91–2.3. Danet Danet A. Psychological impact of COVID-19 pandemic in Western frontline healthcare professionals. A systematic review. Med Clin (Barc). 2021.4. Alonso J, Vilagut G, Mortier P, Ferrer M, Alayo I, Aragón-Pena˜ A, et al. Mental health impact of the first wave of COVID-19 pandemic on Spanish healthcare workers: A large cross-sectional survey. Rev Psiquiatria Salud Mental. 2021.5. Zheng R, Zhou Y, Qiu M, Yan Y, Yue J, Yu L, et al. Prevalence and associated factors of depression, anxiety, and stress among Hubei pediatric nurses during COVID-19 pandemic. Comprehens Psychiatry. 2021:104.6. Liu CY, Yang YZ, Zhang XM, Xu X, Dou QL, Zhang W, et al. The prevalence and influencing factors in anxiety in medical workers fighting COVID-19 in China: A cross-sectional survey. Epidemiol Infect. 2020:148.7. Feinstein RE, Kotara S, Jones B, Shanor D, Nemeroff CB. A health care workers mental health crisis line in the age of COVID-19. Depress Anxiety. 2020;37:822–6.8. da Silva FCT, Neto MLR. Psychological effects caused by the COVID-19 pandemic in health professionals: A systematic review with meta-analysis. Prog Neuro-Psychopharmacol Biol Psychiatry. 2021:104.9. Thombs BD, Saadat N, Riehm KE, Karter JM, Vaswani A, Andrews BK, et al. Consistency and sources of divergence in recommendations on screening with questionnaires for presently experienced health problems or symptoms: A comparison of recommendations from the Canadian Task Force on Preventive Health Care UK National Screening Committee, and US Preventive Services Task Force. BMC Medicine. 2017;15:150.10. Cassiani-Miranda CA, Cuadros-Cruz AK, Torres-Pinzón H, Scoppetta O, Pinzón-Tarrazona JH, López-Fuentes WY, et al. Validity of the Patient Health Questionnaire-9 (PHQ-9) for depression screening in adult primary care users in Bucaramanga. Colombia. Rev Colomb Psiquiatr. 2021;50:11–21.11. Scoppetta O, Cassiani-Miranda CA, Arocha-Díaz KN, Cabanzo-Arenas DF, Campo-Arias A. Validity of the patient health questionnaire-2 (PHQ-2) for the detection of depression in primary care in Colombia. J Affect Disord. 2021;278:576–82.12. Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: The GAD-7. Arch Intern Med. 2006;166:1092–7.13. Ahn J-K, Kim Y, Choi K-H. The psychometric properties and clinical utility of the Korean version of GAD-7 and GAD-2. Front Psychiatry. 2019;10:127.14. Gong Y, Zhou H, Zhang Y, Zhu X, Wang X, Shen B, et al. Validation of the 7-item Generalized Anxiety Disorder scale (GAD-7) as a screening tool for anxiety among pregnant Chinese women. J Affect Disord. 2021;282:98–103.15. Hinz A, Klein AM, Brähler E, Glaesmer H, Luck T, Riedel-Heller SG, et al. Psychometric evaluation of the Generalized Anxiety Disorder Screener GAD-7, based on a large German general population sample. J Affect Disord. 2017;210:338–44.16. Monterrosa-Castro A, Redondo-Mendoza V, Mercado-Lara M. Psychosocial factors associated with symptoms of generalized anxiety disorder in general practitioners during the COVID-19 pandemic. J Invest Med. 2020;68:1228–34.17. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606–13.18. García-Campayo J, Zamorano E, Ruiz MA, Pardo A, Pérez-Páramo M, López-Gómez V, et al. Cultural adaptation into Spanish of the generalized anxiety disorder-7 (GAD-7) scale as a screening tool. Health Qual Life Outcomes. 2010:8.19. Masuyama A, Shinkawa H, Kubo T. Validation and psychometric properties of the Japanese version Fear of COVID-19 Scale among adolescents. 2020. Disponible en: https://psyarxiv.com/jkmut/. Consultado 25 Mar 2021.20. Munoz-Navarro ˜ R, Cano-Vindel A, Moriana JA, Medrano LA, Ruiz-Rodríguez P, Agüero-Gento L, et al. Screening for generalized anxiety disorder in Spanish primary care centers with the GAD-7. Psychiatr Res. 2017;256:312–7.21. Seo JG, Park SP. Validation of the Generalized Anxiety Disorder-7 (GAD-7) and GAD-2 in patients with migraine. J Headache Pain. 2015;16:1–7.22. Zhong QY, Gelaye B, Zaslavsky AM, Fann JR, Rondon MB, Sánchez SE, et al. Diagnostic validity of the generalized anxiety disorder-7 (GAD-7) among pregnant women. PLoS ONE. 2015;10:125096.23. Jordan P, Shedden-Mora MC, Löwe B. Psychometric analysis of the Generalized Anxiety Disorder scale (GAD-7) in primary care using modern item response theory. PLoS ONE. 2017;12(8.).24. Esser P, Hartung TJ, Friedrich M, Johansen C, Wittchen HU, Faller H. The Generalized Anxiety Disorder Screener (GAD-7) and the anxiety module of the Hospital and Depression Scale (HADS-A) as screening tools for generalized anxiety disorder among cancer patients. Psycho-Oncol. 2018;27:1509–16.25. Teo WZY, Soo YE, Yip C, Lizhen O, Chun-Tsu L. The psychological impact of COVID-19 on ‘hidden’ frontline healthcare workers. Int J Soc Psychiatry. 2020. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32779498/.26. Osman A, Wong JL, Bagge CL, Freedenthal S, Gutierrez PM, Lozano G. The Depression Anxiety Stress Scales-21 (DASS-21): further examination of dimensions, scale reliability, and correlates. J Clin Psychol. 2012;68:1322–38.27. Ma Y, Rosenheck R, He H. Psychological stress among health care professionals during the 2019 novel coronavirus disease Outbreak: Cases from online consulting customers. Intens Crit Care Nurs. 2020;61:102905.CC0 1.0 Universalhttp://creativecommons.org/publicdomain/zero/1.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf22024-09-17T19:06:13Z
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