Ruiz Hernández, José Antonio

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Ruiz Hernández, José Antonio

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Ruiz Hernández, José Antonio

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Universidad de Murcia. Departamento de Psiquiatría y Psicología Social

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Open Access
User violence in public mental health services. Comparative analysis of psychiatrists and clinical psychologists
(Taylor and Francis Group, 2020-07-19) Pina, David; Llor Zaragoza, Paloma; Puente López, Esteban; Egea Fuentes, Ángela; Ruiz Hernández, José Antonio; Llor Esteban, Bartolomé; Psiquiatría y Psicología Social
Background: User violence toward health workers is a growing problem. Several studies report that it is increasing and there is also an increase in the number of complaints by these professionals. Within the health system, Mental Health services have been identified as a collective at special risk. Aims: This study aims to examine in greater depth the differences in perceived user violence against health professionals, as well as its consequences, comparing two large groups: psychiatrists and clinical psychologists. Methods: Using a cross-sectional design, self-reported questionnaires were applied to a sample of 138 professionals from all the public centers in the Region of Murcia (southwest of Spain) that have a Mental Health Unit. Results: The results show that psychiatrists are significantly more exposed to user violence, both verbal and physical, revealing a relationship with job dissatisfaction, emotional exhaustion, professional effectiveness, and cynicism. Conclusions: The present study provides evidence on the differences in the perception of violence of users towards psychologists and psychiatrists, being those who show that they claim to be more exposed. Furthermore, this violence is associated with burnout, job dissatisfaction, somatic symptoms, anxiety, or depression, among other consequences.
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Rating criteria of the causal nexus in Whiplash Associated Disorders: a study of interrater reliability
(Elsevier, 2020-06-21) Pina, David; Represas Vázquez, Carlos; Puente López, Esteban; Luna Maldonado, Aurelio; Ruiz Hernández, José Antonio; Llor Esteban, Bartolomé; Psiquiatría y Psicología Social
Introduction The diagnosis of Whiplash Associated Disorders is subject to various criteria, some of a subjective nature, which impedes a high percentage of agreement among raters of the causal nexus. It is necessary to develop an evidence-based methodology to maximize the uniformity of this diagnosis. Our objective is to assess the interrater reliability of four experts in legal medicine who establish the causal nexus of traffic accident patients. Material and method 300 traffic accident patients evaluated by 4 legal medicine experts. They conducted two ratings, one without and one with a study of the biomechanics of the accident. The degree of concordance of the ratings was studied by the intraclass correlation coefficient (ICC) and the concordance index (CI). Results The results of both the intraclass correlation coefficient and the concordance index of the rating prior to the biomechanical study of the injury yield moderate-high values (ICC=.70; CI=.60). Likewise, the values observed in the rating with the study of biomechanics also indicate moderate-high agreement (ICC=.78, CI=.67). Conclusions The study of biomechanics slightly improves concordance. However, the aforementioned study does not help to reduce the proportion of doubtful cases and the levels of improvement are not acceptable. There are significant differences between the classifications, suggesting that the proposed valuation methodology is not uniform enough to reach a consensus. -------------
Open Access
Assessment of Non-physical User Violence and Burnout in Primary Health Care Professionals. The Modulating Role of Job Satisfaction
(Frontiers Media, 2022-02-04) Pina, David; Llor Zaragoza, Paloma; López López, Reyes; Ruiz Hernández, José Antonio; Puente López, Esteban; Galián Munoz, Inmaculada; Martínez Jarreta, Begoña; Psiquiatría y Psicología Social
Introduction: Growing concern about workplace violence shows the need for an evaluation in specific contexts in order to identify the particularities of each professional group. The health sector consists of a group of professionals with high exposure to violence, specially from users. There are differences depending on the professional category or unit in which the professional works. In this regard, Primary Health Care (PHC) is characterized by a personalized and continuous patient treatment over time, which is not exempt from cases of violence. Among the commonly studied consequences of these situations are decreases in job satisfaction and burnout.Objective: The main objective of this study is to analyze the modulating role of job satisfaction in the relationship between non-physical user violence and the onset of burnout.Methods: Cross-sectional comparative descriptive design. The sample consisted of 574 professionals from 39 PHC centers of the Murcian Health Service. Data were collected using two-stage cluster sampling. For data analysis, descriptive analysis, correlations and stepwise hierarchical regression were used to analyze the interaction between the variables.Results: Regression analysis draws a model where non-physical violence and low intrinsic and extrinsic job satisfaction act as modulators of non-physical violence, cynicism and emotional exhaustion.Conclusions: This study provides evidence of the psychological consequences of the perception of user violence in the PHC staff. Furthermore, it is evident that the emergence of burnout syndrome in these professionals is related to exposure to verbal or non-physical violence together with low job satisfaction. In this sense, a circular and bidirectional relationship between the variables studied is proposed as a possible explanatory model.
Open Access
Evaluation of School Climate Behaviors in the School Context: CONVIVE Questionnaire
(SAGE Publications, 2021-03-05) Pina, David; Ruiz Hernández, José Antonio; Ruiz Fernández, Carmen María; Llor Zaragoza, Laura; Pagán Escribano, María; Jiménez Barbero, José Antonio; Puente López, Esteban; Psiquiatría y Psicología Social
School climate research has traditionally been carried out by separating its two main components, prosocial and antisocial behaviors. This is often a partial view of the school climate. Hence, the goal of this study is to develop an evaluation instrument (CONVIVE) that takes into account both perspectives of the school climate through a dual-strategy design, psychometric and non-experimental, cross-sectional, and descriptive-comparative. The sample includes 600 Primary and Secondary Education students from a southeastern region of Spain. Exploratory and Confirmatory Factorial Analysis fit indices were used for the psychometric study. The result is a 26-item instrument (CONVIVE) made up of four scales that evaluate antisocial and prosocial behaviors, both performed toward others and received by peers: Prosocial Behavior Actor, Prosocial Behavior Receiver, Antisocial Behavior Actor, and Antisocial Behavior Receiver. These behaviors differ as a function of sex and the educational stage.
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Perception of sex in the attitude-behavior relationship in school violence. A qualitative study
(Elsevier, 2022-06-03) Pina, David; Marín Talón, María Catalina; Pagán Escribano, María; Cormos, Lucía Simina; Ruiz Hernández, José Antonio; Godoy Fernández, Carmen; Psiquiatría y Psicología Social
School violence is currently a focus of social alarm that generates special interest in research, given its significant impact on the personal, social, school and family environments of children and adolescents. With regard to the prevention and intervention of this social phenomenon, the study of attitudes associated with violent behavior in the school context has been described as an important variable. This study aims to explore attitudes towards school violence, associated behaviors and the influence that the perceived sex could have on this relationship. The sample studied consists of 96 participants from Spanish Elementary Education and Compulsory Secondary Education schools. Through focus groups and thematic analysis of the data, a qualitative study of attitudes associated with violent behavior due to sex is carried out. Seven groups of attitudes were identified: a) associated with gender stereotypes; b) towards Intimate partner violence; c) as a form of attraction; d) as a way to socialize; e) as a way to increase self-esteem; f) as a form of fun, and g) when it is perceived as legitimate. These results could serve as a basis for the creation of evaluation instruments, as well as for the design of prevention and psychological intervention plans based on attitude modification.
Open Access
Classification accuracy and resistance to coaching of the Spanish version of the Inventory of Problems -29 and the Inventory of Problems - Memory: a simulation study with mTBI patients
(Taylor and Francis Group, 2023-08-24) Pina, David; Puente López, Esteban; Rambaud Quiñones, Paula; Ruiz Hernández, José Antonio; Nieto Cañaveras, María Dolores; Shura, Robert D.; Alcazar Crevillén, Andrés; Martinez Jarreta, Begoña; Psiquiatría y Psicología Social
Objective: The present study aims to evaluate the classification accuracy and resistance to coaching of the Inventory of Problems-29 (IOP-29) and the IOP-Memory (IOP-M) with a Spanish sample of patients diagnosed with mild traumatic brain injury (mTBI) and healthy participants instructed to feign. Method: Using a simulation design, 37 outpatients with mTBI (clinical control group) and 213 non-clinical instructed feigners under several coaching conditions completed the Spanish versions of the IOP-29, IOP-M, Structured Inventory of Malingered Symptomatology, and Rivermead Post Concussion Symptoms Questionnaire. Results: The IOP-29 discriminated well between clinical patients and instructed feigners, with an excellent classification accuracy for the recommended cutoff score (FDS ≥ .50; sensitivity = 87.10% for coached group and 89.09% for uncoached; specificity = 95.12%). The IOP-M also showed an excellent classification accuracy (cutoff ≤ 29; sensitivity = 87.27% for coached group and 93.55% for uncoached; specificity = 97.56%). Both instruments proved to be resistant to symptom information coaching and performance warnings. Conclusions: The results confirm that both of the IOP measures offer a similarly valid but different perspective compared to SIMS when assessing the credibility of symptoms of mTBI. The encouraging findings indicate that both tests are a valuable addition to the symptom validity practices of forensic professionals. Additional research in multiple contexts and with diverse conditions is warranted.
Open Access
Users' perception of violence and conflicts with professionals in Primary Care centers before and during COVID-19. A qualitative study
(Frontiers Media, 2021-12-16) Pina, David; López Ros, Paloma; Luna Maldonado, Aurelio; Luna Ruiz-Caballero, Aurelio; Llor Esteban, Bartolomé; Ruiz Hernández, José Antonio; García Jiménez, Jesús Javier; Puente López, Esteban; Martínez Jarreta, Begoña; Psiquiatría y Psicología Social
Background: Workplace violence is a social problem of special interest in both intervention and research. Among the sectors that most perceive this type of violence, health care professionals stand out. The most common type of violence for this professional group is the one perpetrated by the users or patients themselves. It has been reported that one out of every four acts of violence in the workplace occurs in the healthcare setting. Within the health sector, the Mental Health, Emergency and Primary Care services have been widely reported as being among the most vulnerable, with Primary Care being the least addressed of the three. Although the available literature is extensive, there are hardly any studies that explore from a qualitative perspective what are the sources of conflict in this sector from the perspective of the users, the most common being to work with professionals. Objective: The aim of this study is to examine those aspects derived from the organization, the professionals or the users of Primary Care that, from the users' point of view, cause violent situations and how they think these could be avoided. Method: The sample consisted of 80 users of the Primary Care services of the Health Service of Murcia. For data collection, a qualitative study was conducted through 10 focus groups and a subsequent thematic analysis of the data. Results: The results have allowed us to identify that, from an organizational point of view, the uncertainty in waiting times, the need to adapt the telematic or telephone appointment to the different types of users, or the management of emergencies in Primary Care are the aspects that cause most conflicts between users and professionals. In this sense, suggested improvements are aimed at providing information in the mobile application updated on the opening hours or maintaining the telephone appointment for those who need or request it, among many others. As for the professionals, users point out that the medical staff is perceived as distant and sometimes does not provide enough information on the health status of users. Another professional group widely addressed in the focus groups was the administrative staff, being described as lacking in communication skills, assertiveness, or empathy. Users recognize the existence of a demanding/aggressive profile among users, who makes instrumental use of violence to achieve privileges over users in general. We have also identified the profile of the user who makes use of Primary Care as a way of socializing or managing conflicts of a socioemotional nature. As proposals for this thematic block, users suggest group therapies, the use of audiovisual material complementary to the information provided by professionals or community interventions in psychoeducation. Conclusion: This study allows to explore conflicts between users and professionals from the Primary Care patients' perspective. Our results are complementary to the available evidence that has used the professional's approach to study the phenomenon of workplace violence. The identification of sources of conflict and the assessment and contribution of users on possible ways of improvement can serve as a basis for the design of prevention and intervention plans to improve the work environment in Primary Care centers.
Open Access
Diagnostic accuracy of the Structured Inventory of Malingered Symptomatology (SIMS) in motor vehicle accident patients
(Taylor and Francis Group, 2020-10-12) Pina, David; Puente López, Esteban; Ruiz Hernández, José Antonio; Llor Esteban, Bartolomé; Psiquiatría y Psicología Social
The SIMS is used in the medico-legal context to assess people who have suffered a traffic accident without proven scientific evidence to support this procedure. The objective of this research is to evaluate the SIMS’ ability to discriminate instructed malingerers, general population, patients who have suffered a traffic accident, and overreporting patients. A simulation design was used to evaluate a total of 650 subjects divided into the four mentioned groups. Our results indicate that the cut-off scores proposed by the authors of the English and Spanish versions (14 and 16) produce moderate sensitivity and specificity values. With a cut-off score of 10, specificity decreases, but sensitivity significantly increases. These results suggest that the SIMS needs to be adapted to the context’s particularities, either by using the proposed cut-off score and other instruments that compensate for the low specificity or by designing new subscales that include symptoms that are typical for the usual conditions in the context.
Open Access
Attitudes toward school violence against LGBTQIA+. A qualitative study
(MDPI, 2021-10-29) Pina, David; Marín Talón, María Catalina; López López, Reyes; Martínez Sánchez, Ainhoa; Cormos, Lucía Simina; Ruiz Hernández, José Antonio; Abacea, Begoña; Martínez Jarreta, Begoña; Psiquiatría y Psicología Social
School climate is one of the main concerns in terms of research and intervention worldwide. Although it can be directed toward any student, some groups seem to be more vulnerable, as is the case of the LGBTQIA+ (lesbian, gay, bisexual, transgender, queer and intersex +) students, among others. Attitudes toward violence are a construct of particular importance for action plans focused on improving school coexistence. The aim of this study is to examine attitudes toward school violence against LGBTQIA+ students and their relationship with violent behaviors. For this purpose, 96 Spanish students of Spanish elementary education (PE) and compulsory secondary education (CSE) participated in this qualitative study through focus groups for its subsequent thematic analysis. The results identify four types of attitudes toward violence, such as the use of violence as a form of fun, to feel better, when it is perceived as legitimate, and as a way of relating to the LGBTQIA+ community. In addition, a greater number of negative attitudes and violent behaviors toward homosexual boys and transgender minors are observed.
Open Access
Violencia de usuarios hacia profesionales sanitarios y no sanitarios en servicios de urgencias hospitalarias. Estudio transversal descriptivo-comparativo
(Ministerio de Sanidad y Consumo, 2021-07-12) Pina, David; Cánovas Pallarés, Juan Manuel; Ruiz Hernández, José Antonio; Galián Muñoz, Inmaculada; Pardo Ríos, Manuel; Llor Esteban, Bartolomé; Puente López, Esteban; Psiquiatría y Psicología Social
Fundamentos: La violencia laboral es un problema de Salud Pública que afecta a profesionales de los Servicios de Urgencias Hospitalarias, siendo este entorno donde existe una intensa interacción con los pacientes usuarios y/o familiares que precisan cuidados críticos y/o especiales. Con ello, el objetivo de este trabajo fue evaluar la exposición a la violencia de los usuarios percibida por los distintos profesionales sanitarios y no sanitarios de los Servicios de Urgencias pertenecientes a once hospitales españoles. Métodos: El diseño fue una estrategia asociativa, de corte transversal, resultando un estudio descriptivo-comparativo, desarrollado en 2019, con una muestra de 584 profesionales sanitarios y no sanitarios de once servicios españoles de Urgencias Hospitalarias de ocho comunidades autónomas españolas. Se utilizaron estadísticos no paramétricos para las comparaciones entre grupo, análisis post-hoc y el cálculo de la magnitud del efecto. Resultados: El 100% de los encuestados reconocieron haber sufrido violencia laboral al menos una vez en el último año. Específicamente, en cuanto a violencia no física, al menos ocho de cada diez profesionales estuvieron expuestos (rango 85,1%-100%). El grupo que más percibió esta violencia fue administración, seguidos de los profesionales sanitarios de enfermería y medicina, así como de los técnicos de cuidados auxiliares de enfermería (T.C.A.E) (H=28,881; p=0,001). Por otro lado, las manifestaciones de violencia física afectaron aproximadamente a tres de cada diez profesionales (rango 22,6%-29,5%), estando más presente en T.C.A.E y seguidos de los profesionales sanitarios de medicina y enfermería, así como de los profesionales no sanitarios, celadores y administración (H=9,800; p=0,05). Conclusiones: Nuestro estudio evidencia la alta prevalencia de conductas violentas de media o baja intensidad en los servicios de Urgencias y Emergencias españoles. Además, permite profundizar en las distintas manifestaciones de violencia recibidas por los principales grupos profesionales de estos servicios. ------------