María Ladisa

Mental disorders are a leading cause of morbidity worldwide, and healthcare professionals are particularly vulnerable due to occupational stressors, a vulnerability intensified during the coronavirus disease 2019 pandemic. This study assessed the prevalence of mental health disorders among hospital workers and examined changes in their perceived mental health during the pandemic. A descriptive cross-sectional study was conducted with 215 employees attending the Health Surveillance Service of Virgen Macarena University Hospital (Seville) between January 2019 and December 2022. Data were collected from occupational health records and a telephone survey, including the General Health Questionnaire (12 items) questionnaire. The prevalence of diagnosed mental health disorders was 7.0%, with mixed anxiety-depressive disorder being the most frequent. Most affected workers required short-term temporary incapacity due to common contingencies, and 36.7% required job adaptations, mainly involving task modifications. During the pandemic, 68.1% of workers reported a perceived worsening in mental health, which was more common among alcohol users. Among those receiving treatment, 70.8% required medication adjustments, and 31.2% reported increased analgesic use. Although prevalence rates were lower than expected, likely due to underdiagnosis and prioritization of coronavirus disease 2019-sensitive evaluations, the profile of affected workers was consistent with previous literature, predominantly women around 50 years old, often Assistant Nursing Care Technicians. These findings highlight the crucial role of occupational health services in early detection, monitoring, and support of healthcare professionals. Identification of alcohol use, psychiatric medication adjustments, and increased analgesic intake as risk factors emphasize the need for proactive interventions to sustain the healthcare workforce.

Background: During the first wave of the COVID-19 pandemic, the importance of the recognition of vulnerable workers was well-established, but the specific impact of the timing of their recognition remains less understood. Objective: This study evaluates the impact of early recognition of vulnerable healthcare workers (VHCWs) and identifies factors associated with SARS-CoV-2 infection. Methods: We performed a retrospective cohort study at the Virgen Macarena University Hospital (HUVM) in Seville and included employees classified as VHCWs between January 2020 and December 2021. All data, including demographic, occupational, and clinical data, were collected from occupational health records and the Andalusian digital health system. The incidence of COVID-19 was analyzed using descriptive, bivariate statistics, and Cox regression. Results: A total of 471 VHCWs were included. Most of the VHCWs were women (79.8%) with a median age of 50 years. The most common vulnerability criteria were pregnancy (32.9%) and age > 60 (28.7%). During the study period, 58 VHCWs (12.3%) were diagnosed with COVID-19, compared to 18.35% of the general workforce. Recognition of VHCW status after the pandemic was declared was strongly associated with higher infection risk (HR = 48.84; 95% CI: 26.21–90.99; p < 0.001). Conclusions: The timing of vulnerability recognition emerged as the most critical protective factor in this cohort. Healthcare workers whose vulnerability was not proactively identified before the pandemic onset faced a substantially higher risk of infection (HR = 44.68; 95% CI: 26.21–90.99; p < 0.001) compared to those recognized early. These findings underscore that pre-pandemic identification facilitated the immediate implementation of task adaptations and workplace restrictions, effectively mitigating high-risk exposure during the most critical early stages of the crisis.

This study aims to evaluate evacuation performance in a high-acuity intensive care unit (ICU) by integrating building information modeling (BIM) and computational simulation and examine how different parametrizations affect the fidelity of predicted evacuation dynamics when compared with data from a real evacuation drill. A detailed BIM model of a tertiary hospital ICU was developed and imported into Pathfinder to simulate 3 protocol-based evacuation scenarios and 1 scenario calibrated with preparation times obtained from a 2024 evacuation drill. Simulations assessed occupant flow, bottlenecks, movement trajectories, and total evacuation times. Architectural constraints, behavioral rules, and patient dependency profiles were incorporated to reflect real operational conditions, including explicit geometric incompatibilities between door widths and ICU bed dimensions. Evacuation times produced with generic parameters showed a gap of up to 7 minutes 40 seconds less than the real drill duration, whereas the empirically calibrated simulation narrowed this difference to 2 minutes 30 seconds. Across all scenarios, bottlenecks consistently emerged at the main critical patient unit exit, primarily driven by architectural constraints such as insufficient door widths relative to bed size, which hindered bed maneuverability and intensified staff circulation conflicts. Flow rates peaked between 0.40 and 0.55 persons/s, with higher occupancy producing more sustained congestion. Preparatory actions for clinically complex patients significantly shaped overall evacuation performance. The integration of BIM and empirically informed simulation enhances the accuracy and operational relevance of evacuation analyses in complex clinical environments. Findings highlight the need for calibration based on real behavioral data and demonstrate how specific architectural mismatches, particularly between door geometry and bed dimensions, act as critical drivers of evacuation bottlenecks. This approach supports more robust risk assessment and emergency planning within critical socio-technical infrastructures.

Cardiac rehabilitation programs (CRPs) are multifactorial interventions defined by the World Health Organization as essential strategies to improve patients’ health-related quality of life (HRQoL) by enhancing their physical, psychological, social, and occupational well-being. These programs are a cornerstone in the comprehensive treatment of heart disease, facilitating the recovery of functional capacity and reintegration into the workforce through a multidisciplinary approach. The objective of this study was to assess the efficacy of CRPs in enhancing functional capacity (cardiac and psychological) and HRQoL in workers with ischemic heart disease. An observational pre-post study without a control group was conducted, focusing on actively employed individuals with ischemic heart disease. A total of 214 patients were included, selected according to specific inclusion criteria after excluding those not suitable for longitudinal follow-up. Participants were active workers aged 18 to 65 years who were prescribed a CRP between January 2020 and December 2021. Sociodemographic, occupational, cardiovascular risk, and clinical-therapeutic data were collected to evaluate changes following completion of the program. Health-related quality of life (HRQoL) was also assessed. A total of 214 patients were included, 83.9% male, with a mean age of 54.21 years. Most had a history of hypertension, dyslipidemia, smoking, low physical activity, overweight or obesity, and a family history of ischemic heart disease. Among those who started the program (94.4%), the most common diagnosis was acute myocardial infarction involving a single coronary vessel. Additionally, 77.1% underwent stent angioplasty, and 47.2% participated in a moderate-risk CRP. After completion, the SF-36 score improved significantly (46.92 vs 70.21), and depressive symptoms decreased (55.10% vs 38.22%). Significant benefits were observed in most modifiable cardiovascular risk factors, along with an increase in the proportion of patients with preserved left ventricular ejection fraction (65.4% vs 72%) and in metabolic equivalent (MET) levels. In 157 participants (73.4%), MET gain was quantified, with a mean increase of 2.67 ± 1.64 METs. These findings suggest that cardiac rehabilitation, as a secondary prevention strategy, effectively improves cardiac function and HRQoL in working-age patients with ischemic heart disease.

This study aimed to examine the employment status of patients who have experienced ischemic heart disease one year after undergoing cardiac rehabilitation. For this, a quasi-experimental pre-post study without a control group of active workers aged 18 to 65 years diagnosed with ischemic heart disease and included in a cardiac rehabilitation programme was conducted. Sociodemographic and occupational data, cardiovascular risk factors and clinical-therapeutic data on heart disease were collected. A total of 214 patients were included, of which 115 patients returned to work. Several clinical factors contributing to return to work were identified: preserved left-ventricular ejection fraction (≥55%), < 3 obstructed coronary vessels, and stent revascularisation. Socio-occupational factors that may positively influence return to work were identified: age < 50 years, absence of anxious-depressive symptoms, higher level of education, and occupations with low physical strain. Cardiac rehabilitation is effective in improving cardiac function and health-related quality of life in workers with ischemic heart disease. Return to work and duration of temporary incapacity were associated with clinical-therapeutic variables and psycho-socio-occupational factors, such as type of job, physical strain, anxiety and depression, and age of the worker.