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ORIGINAL
Salud mental de los estudiantes de enfermería ante el terremoto de Marruecos: un estudio transversal
Mental health of nursing students regarding the Moroccan earthquake: A cross-sectional study
Mounia Amanea,
Autor para correspondencia
mouniaamane9@gmail.com

Autor para correspondencia.
, Nadia Hachoumia, Rkia Laabidia, Loubna Mazzia, Souad Yakinia, Sokaina Loulidib, Siham Jbaria, El Hassane Mouridc, Samia Boussaad
a ISPITS-Higher Institute of Nursing Professions and Technical Health of Marrakech, Morocco
b Laboratory of Pharmacology, Neurobiology, Anthropobiology and Environment, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech 40000, Morocco
c Interdisciplinary Laboratory for Research in Bio-resources, Environment and Materials, Higher normal school, Cadi Ayyad University, Marrakesh, Morocco
d ISPITS-Higher Institute of Nursing and Technical Health Occupations, Ministry of Health and Social Protection, Rabat, Morocco
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incluyendo la zona rural de Marruecos&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">De hecho&#44; recientemente&#44; durante la tarde del 8 de septiembre de 2023&#44; y hasta el s&#225;bado 9 de septiembre&#44; un fuerte terremoto de magnitud 6&#44;9 devast&#243; el oeste de Marruecos&#46; El epicentro del temblor se situ&#243; a casi 70 km del sudoeste de Marrakech&#44; en la provincia de Al-Haouz &#40;N31&#46;07&#59; W8&#46;41&#41;&#46; Veinte minutos despu&#233;s&#44; se produjo una r&#233;plica de magnitud 4&#44;9&#46; Las zonas gravemente afectadas por el terremoto albergan a casi 2 millones de personas&#46; Se piensa que 50&#46;000 viviendas quedaron completa o parcialmente destruidas&#46; Los c&#225;lculos m&#225;s recientes muestran que aproximadamente 5&#46;500 personas resultaron heridas&#44; y m&#225;s de 3&#46;000 murieron<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">2</span></a>&#46; Adem&#225;s del impacto econ&#243;mico y social&#44; 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Los terremotos pueden tener una influencia prejudicial significativa en la salud mental&#44; debido al estr&#233;s y la preocupaci&#243;n que inducen causados por las p&#233;rdidas materiales y humanas<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">8</span></a>&#46; De acuerdo con la revisi&#243;n en la literatura de diversos estudios<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">9</span></a>&#44; a pesar del hecho de que muchas personas expresaron angustia psicol&#243;gica grave&#44; la resiliencia es evidente&#46; Aun cuando podr&#237;a haber habido implantados mecanismos de resiliencia casi de inmediato al terremoto&#44; pueden haber existido riesgos a medio y largo plazo debido a los cambios de la vida diaria y la interrupci&#243;n de las redes sociales&#44; que pueden estar vinculados a cuestiones de salud mental&#46; En el terremoto de Siria&#44; la mayor&#237;a de la poblaci&#243;n report&#243; trastornos probables de estr&#233;s postraum&#225;tico&#44; depresi&#243;n o ansiedad<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">10</span></a>&#46; Tambi&#233;n se ha estudiado el efecto del terremoto en poblaciones espec&#237;ficas&#46; Por un lado&#44; los desastres naturales pueden tener un impacto negativo en los procesos de aprendizaje universitario&#44; pudiendo tener tambi&#233;n consecuencias sociales&#44; psicol&#243;gicas y econ&#243;micas devastadoras para el aprendizaje de los estudiantes profesionales<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">11</span></a>&#46; Por otro lado&#44; numerosos estudios<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">12&#44;13</span></a> han demostrado que los trabajadores sanitarios pueden ser m&#225;s susceptibles a los trastornos de salud mental&#44; incluyendo estr&#233;s postraum&#225;tico&#44; agotamiento&#44; deterioro de la calidad de vida&#44; estr&#233;s psicol&#243;gico&#44; depresi&#243;n e impacto en la resiliencia psicol&#243;gica debido a su exposici&#243;n directa a los efectos del terremoto&#46; El incremento de la presi&#243;n por aportar atenci&#243;n m&#233;dica de urgencia en circunstancias dif&#237;ciles&#44; el estr&#233;s de manejar recursos escasos y la toma de decisiones r&#225;pida&#44; as&#237; como los recuerdos terribles de ver a las v&#237;ctimas del terremoto pueden haber sido causas contributivas a dichas consecuencias<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">12&#44;13</span></a>&#46; Los estudiantes de enfermer&#237;a&#44; como estudiantes profesionales de educaci&#243;n superior&#44; pueden ser particularmente vulnerables a los efectos adversos en la salud mental tras un terremoto&#44; debido a su rol potencial en la respuesta urgente y a los retos asociados a la prestaci&#243;n de atenci&#243;n m&#233;dica en condiciones de crisis&#46; Sin embargo&#44; solo se ha encontrado un estudio que examinara la salud mental de los estudiantes de enfermer&#237;a en el periodo posterior al terremoto<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">14</span></a>&#46; El objetivo de esta investigaci&#243;n fue evaluar la salud mental de los estudiantes transcurridos seis meses del terremoto de Marruecos&#44; as&#237; como los factores asociados&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">M&#233;todos</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Dise&#241;o y muestra del estudio</span><p id="par0045" class="elsevierStylePara elsevierViewall">Se realiz&#243; una encuesta transversal a los estudiantes de enfermer&#237;a en marzo de 2024&#44; transcurridos seis meses del terremoto de Marruecos&#46; Los estudiantes de enfermer&#237;a hab&#237;an estado implicados en los cuidados a las v&#237;ctimas del terremoto&#44; bien en el sitio del desastre o en las redes hospitalarias para aquellos que hab&#237;an sido trasladados&#46; Por tanto&#44; se incluy&#243; en el estudio a la instituci&#243;n acad&#233;mica enfermera &#40;ISPITS&#41; m&#225;s cercana al epicentro del terremoto de Marruecos y sus distritos afectados&#46; Se seleccion&#243; el muestreo de la clase a fin de dar acceso a los cinco campos de grados de enfermer&#237;a ISPITS&#46; Por ello&#44; considerando la poblaci&#243;n total &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;000&#41;&#44; un intervalo de confianza &#40;IC&#41; del 95&#37;&#44; y un de nivel de significaci&#243;n del 5&#37;&#44; el n&#250;mero m&#237;nimo de participantes necesarios para el estudio se calcul&#243; en al menos 278 personas&#44; utilizando el programa <span class="elsevierStyleItalic">online</span> &#171;Survey Monkey&#187;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">15</span></a>&#46; Por tanto&#44; se distribuy&#243; el cuestionario a 300 estudiantes para evitar las respuestas no completas o rechazadas que afectaran al tama&#241;o muestral&#46; El periodo de la encuesta se alej&#243; de los ex&#225;menes para neutralizar cualquier sesgo que pudiera generarse durante dicho periodo&#44; como resultado del estr&#233;s de los mismos&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Aprobaci&#243;n &#233;tica</span><p id="par0050" class="elsevierStylePara elsevierViewall">El comit&#233; de &#233;tica regional del centro de investigaci&#243;n m&#233;dica de Marrakech otorg&#243; su autorizaci&#243;n &#233;tica &#40;ref&#46; 302&#47;23&#41;&#46; Tambi&#233;n se obtuvo autorizaci&#243;n del ISPITS &#40;ref&#46; 29&#47;23&#41;&#46; Antes de entregar los cuestionarios se garantiz&#243; la anonimidad&#44; el consentimiento verbal de los estudiantes y dem&#225;s cuestiones &#233;ticas&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Recopilaci&#243;n de los datos</span><p id="par0055" class="elsevierStylePara elsevierViewall">La encuesta se dividi&#243; en cuatro secciones&#58; 1&#41; datos sociodemogr&#225;ficos&#59; 2&#41; salud mental &#40;ansiedad&#44; depresi&#243;n y estr&#233;s&#41; entre los estudiantes&#59; 3&#41; trastorno de estr&#233;s postraum&#225;tico tras el terremoto&#59; y 4&#41; valoraci&#243;n del estado de resiliencia&#46; Se utilizaron tres medidas psicom&#233;tricas validadas para evaluar la resiliencia y la salud mental tras los desastres&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">En esta investigaci&#243;n se utiliz&#243; la versi&#243;n validada breve de 21 &#237;tems de la <span class="elsevierStyleItalic">Depression&#44; Anxiety and Stress Scale</span> &#40;DASS&#41;-21<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">16</span></a>&#46; La escala DASS se desarroll&#243; por primera vez en 1995 con 42 preguntas&#44; y fue validada en m&#250;ltiples idiomas&#44; incluyendo la lengua &#225;rabe<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">17</span></a>&#46; Los &#237;tems se miden utilizando una escala de gravedad autoreportada de cuatro puntos &#40;0-3&#41; con tres subescalas que miden la sintomatolog&#237;a del estr&#233;s &#40;&#237;tems 1&#44; 6&#44; 8&#44; 11&#44; 12&#44; 14&#44; 18&#41;&#44; la ansiedad &#40;&#237;tems 2&#44; 4&#44; 7&#44; 9&#44; 15&#44; 19&#44; 20&#41; y la depresi&#243;n &#40;&#237;tems 3&#44; 5&#44; 10&#44; 13&#44; 16&#44; 17&#44; 21&#41;&#46; Se utiliz&#243; el enfoque de Lovibond et al&#46; para determinar las categor&#237;as de gravedad para cada categor&#237;a de DASS&#46; Los siguientes son umbrales sugeridos para las etiquetas de gravedad tradicionales&#58; DASS-<span class="elsevierStyleItalic">Anxiety</span> &#40;DASS-A&#41; &#40;Normal<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0-7&#59; Leve<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8-9&#59; Moderada<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10-14&#59; Grave<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15-19&#59; Extremadamente grave 20&#43;&#41;&#44; DASS-<span class="elsevierStyleItalic">Stress</span> &#40;DASS-S&#41; &#40;Normal<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0-7&#59; Leve<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8-9&#59; Moderado<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10-14&#59; Grave<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15-19&#59; Extremadamente grave 20&#43;&#41;&#44; y DASS-<span class="elsevierStyleItalic">Depression</span> &#40;DASS-D&#41; &#40;Normal<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0-14&#59; Leve<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15-18&#59; Moderada<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>19-25&#59; Grave<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>26-33&#59; Extremadamente grave 34&#43;&#41;&#46; Las puntuaciones de DASS-21 deber&#225;n multiplicarse por dos para calcular la puntuaci&#243;n final<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">18</span></a>&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">La segunda herramienta fue PCL-L &#40;<span class="elsevierStyleItalic">Post-traumatic Stress Disorder Checklist-Civilian</span> &#40;PCL-C&#41; con 17 &#237;tems<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">19</span></a>&#44; con versiones validadas en diferentes idiomas&#44; que constan de 17 o 20 &#237;tems incluyendo la versi&#243;n en &#225;rabe<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">20-22</span></a>&#46; Los &#237;tems se miden utilizando una escala de cinco puntos &#40;1-5&#41;&#44; pudiendo oscilar las puntuaciones de 17 a 85&#46; Las puntuaciones m&#225;s altas indican un mayor deterioro&#46; En este estudio&#44; se utilizaron las puntuaciones superiores a 35 para identificar qu&#233; puntuaciones se escapaban del rango &#171;normal&#187;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">14</span></a>&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">La <span class="elsevierStyleItalic">Connor-Davidson Resilience Scale</span> &#40;CD-RISC&#41; es una escala de 25 &#237;tems<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">23</span></a>&#44; con una versi&#243;n en &#225;rabe para mujeres<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">24</span></a> y estudiantes universitarios<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">25</span></a>&#46; La versi&#243;n en &#225;rabe breve de CD-RISC utilizada en esta investigaci&#243;n incluye 10 &#237;tems<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">26</span></a>&#44; puntu&#225;ndose cada uno de ellos en una escala de 5 puntos que fluct&#250;a de 0 &#40;para nada cierto&#41; a 4 &#40;cierto casi todo el tiempo&#41;&#46; Las puntuaciones fluct&#250;an de 0 a 40&#44; indicando las puntuaciones m&#225;s altas de CD-RISC-10 unos niveles m&#225;s altos de resiliencia<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">14</span></a>&#46; Consideramos las puntuaciones superiores a 30 como niveles altos de resiliencia en la descripci&#243;n cualitativa&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">El cuestionario fue probado con 30 estudiantes&#44; los cuales fueron excluidos de la muestra&#46; El tiempo medio de respuesta se situ&#243; entre 15 y 30 minutos&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">An&#225;lisis de los datos</span><p id="par0080" class="elsevierStylePara elsevierViewall">Tras la recopilaci&#243;n de los datos y su codificaci&#243;n en el software SPSS &#40;<span class="elsevierStyleItalic">Statistical Package for the Social Sciences</span> versi&#243;n 24&#46;0-IBM&#44; Armonk&#44; NY&#44; EE&#46; UU&#46;&#41;&#44; se realiz&#243; un an&#225;lisis deductivo y descriptivo&#46; Se utilizaron frecuencias y porcentajes para presentar los datos descriptivos&#46; Adem&#225;s&#44; se utilizaron media&#44; desviaci&#243;n est&#225;ndar &#40;DE&#41;&#44; mediana y rango intercuart&#237;lico para describir la distribuci&#243;n central de los datos&#46; Tambi&#233;n se realiz&#243; una correlaci&#243;n entre escalas y un an&#225;lisis exploratorio para investigar las diferencias potenciales entre las caracter&#237;sticas de la poblaci&#243;n de estudio y las puntuaciones de la escala&#46; Se verific&#243; la normalidad de la distribuci&#243;n mediante la prueba de Kolmog&#243;rov-Smirnov&#46; Se utiliz&#243; la prueba <span class="elsevierStyleItalic">U</span> de Mann-Whitney para los datos sin distribuci&#243;n no Gaussiana&#46; Por &#250;ltimo&#44; se calcul&#243; el coeficiente alfa de Cronbach para verificar la fiabilidad de los resultados en el contexto marroqu&#237;&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Resultados</span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Caracter&#237;sticas de la poblaci&#243;n</span><p id="par0085" class="elsevierStylePara elsevierViewall">Doscientos sesenta y un participantes completaron el cuestionario&#44; de entre 300 individuos contactados&#44; con una tasa de respuesta del 87&#37;&#46; La edad de la poblaci&#243;n fluctu&#243; de 17 a 33 a&#241;os&#44; con una media de 19&#44;58 a&#241;os y una DE de 2&#44;117 a&#241;os&#46; Como se muestra en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#44; nuestra poblaci&#243;n fue predominantemente femenina &#40;80&#44;1&#37;&#59; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>209&#41;&#44; totalizando los participantes de las zonas del desastre el 29&#44;9&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>78&#41;&#46; La mayor&#237;a de los respondedores viv&#237;a con sus familias &#40;72&#44;4&#37;&#59; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>189&#41;&#46; Los estudiantes de atenci&#243;n enfermera representaron el 82&#44;4&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>215&#41;&#44; mientras que los estudiantes de tercer a&#241;o no representaron m&#225;s del 11&#44;5&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>30&#41; de todos los participantes&#46; Casi todos los respondedores &#40;96&#44;9&#37;&#59; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>253&#41; hab&#237;an experimentado el terremoto&#44; &#250;nicamente el 1&#44;1&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#41; hab&#237;a perdido un familiar en este desastre natural&#44; y el 23&#44;4&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>61&#41; hab&#237;a sufrido da&#241;o material en su hogar&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Resultados de las puntuaciones descriptivas</span><p id="par0090" class="elsevierStylePara elsevierViewall">El estudio de la normalidad de los datos realizado mediante la prueba de Kolmog&#243;rov-Smirnov reflej&#243; que los valores de las puntuaciones presentes no siguen una distribuci&#243;n normal&#44; lo cual implica el uso de pruebas espec&#237;ficas no param&#233;tricas para el an&#225;lisis adicional de la correlaci&#243;n y asociaci&#243;n&#46; Adem&#225;s&#44; los resultados reflejaron que todos los &#237;tems de dichas escalas utilizadas tienen una alta fiabilidad en el contexto marroqu&#237;&#44; seg&#250;n lo demostrado por los valores del coeficiente alfa de Cronbach&#44; que supera 0&#44;87 en todas las escalas&#46; La ansiedad de diversos grados &#40;Leve&#59; Moderada&#59; Grave&#59; Extremadamente grave&#41; estuvo presente en el 44&#44;8&#37; de los participantes&#44; con una media de 7&#44;22 y una mediana de 7&#46; La depresi&#243;n de grado leve y moderado afect&#243; al 37&#44;1&#37; de los estudiantes&#44; mientras que la media y mediana reportadas para la poblaci&#243;n de estudio fueron de 7&#44;55 y 7&#44; respectivamente&#46; El estr&#233;s de tipo leve y moderado fue reportado por solo el 7&#44;7&#37; de los estudiantes&#44; con una media de 6&#44;89 y una mediana de 6&#46; Los estudiantes dentro del rango de estr&#233;s postraum&#225;tico anormal superaron la mitad de los participantes &#40;61&#44;3&#37;&#41;&#44; con una media de 40&#44;7 y una mediana de 38&#46; Por &#250;ltimo&#44; nuestros resultados reflejaron que solo una minor&#237;a de los estudiantes obtuvo la puntuaci&#243;n de resiliencia &#40;13&#44;8&#37;&#41; con una media de 21&#44;04 y una mediana de 22 &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46; La correlaci&#243;n entre las diferentes escalas reflej&#243; una asociaci&#243;n positiva entre todos los valores de las escalas utilizadas&#44; con excepci&#243;n de la escala de evaluaci&#243;n de la resiliencia&#44; que tuvo un coeficiente de correlaci&#243;n negativo con el resto de las escalas &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a></p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Factores asociados a la salud mental de los estudiantes de enfermer&#237;a</span><p id="par0095" class="elsevierStylePara elsevierViewall">Los resultados reflejaron que la edad afecta significativamente a la salud mental de los estudiantes de enfermer&#237;a&#46; De hecho&#44; la escala DAS &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;034&#41;&#44; y m&#225;s espec&#237;ficamente la escala de ansiedad &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;018&#41; se correlacion&#243; negativamente con la edad&#44; lo cual significa que los estudiantes de mayor edad obtuvieron menores puntuaciones&#44; es decir&#44; valores normales de ansiedad&#46; Adem&#225;s&#44; con excepci&#243;n de la escala de resiliencia&#44; el sexo femenino obtuvo medianas m&#225;s altas que el sexo masculino para todas las escalas&#44; con una diferencia significativa en la puntuaci&#243;n de la escala DAS&#44; y m&#225;s espec&#237;ficamente la puntuaci&#243;n de ansiedad y estr&#233;s &#40;p &#706; 0&#44;05&#41;&#46; De igual modo&#44; los estudiantes que viv&#237;an con sus familias ten&#237;an una mediana de puntuaci&#243;n de resiliencia m&#225;s alta que los estudiantes que viv&#237;an solos o en una vivienda compartida&#44; lo cual refleja una diferencia significativa &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;042&#41;&#46; Adem&#225;s&#44; el curso de estudio y la p&#233;rdida de un familiar en el terremoto afect&#243; significativamente a la escala DASS &#40;p &#706; 0&#44;05&#41;&#44; donde los estudiantes de tercero y aquellos que hab&#237;an perdido un familiar en el desastre natural ten&#237;an una mediana m&#225;s alta que los estudiantes de otros grados y aquellos que hab&#237;an reportado no haber perdido un familiar&#46; Por ello&#44; fue significativa la asociaci&#243;n entre el curso de estudio y todas las subescalas de DAS&#58; depresi&#243;n &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007&#41;&#44; estr&#233;s &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007&#41; y ansiedad &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41;&#46; Tambi&#233;n fue significativa entre el hecho de perder un familiar y las diferentes escalas de depresi&#243;n &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;047&#41;&#44; estr&#233;s &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;006&#41; y ansiedad &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;021&#41;&#46; Por &#250;ltimo&#44; la escala de estr&#233;s postraum&#225;tico solo se vio afectada por el da&#241;o material y&#44; de hecho&#44; los estudiantes que hab&#237;an declarado un da&#241;o material en sus viviendas fueron aquellos que tuvieron puntuaciones medias m&#225;s altas en la lista de comprobaci&#243;n PCL&#44; con una diferencia significativa de los estudiantes que no hab&#237;an declarado dicho da&#241;o &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;044&#41;&#46; Sin embargo&#44; este estudio no estableci&#243; ninguna asociaci&#243;n entre la salud mental de los estudiantes de enfermer&#237;a y la asistencia y experiencia del fen&#243;meno o el vivir cerca del foco del terremoto &#40;procedencia&#41;&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Discusi&#243;n</span><p id="par0100" class="elsevierStylePara elsevierViewall">La presente investigaci&#243;n destac&#243; el impacto significativo del terremoto en la salud mental de los estudiantes de enfermer&#237;a&#44; utilizando tres medidas psicom&#233;tricas validadas&#58; PCL-C&#44; DASS-21 y CD-RISC para evaluar la salud mental de los estudiantes de enfermer&#237;a tras el terremoto de Marruecos&#46; Se eligieron las escalas de recopilaci&#243;n de los datos analizando las variables de salud mental m&#225;s estudiadas en los desastres naturales&#44; y consultando estudios previos que examinan la validez y fiabilidad de dichas herramientas en los contextos &#225;rabes&#46; Esta elecci&#243;n de la escala&#44; traducida y adaptada al contexto &#225;rabe<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">17&#44;21&#44;26</span></a>&#44; se reflej&#243; sustancialmente en la alta fiabilidad de las escalas e &#237;tems utilizados en el contexto marroqu&#237;&#44; a partir de los resultados presentes&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">La ansiedad estuvo presente en el 44&#44;8&#37; de los participantes&#46; La depresi&#243;n afect&#243; al 37&#44;1&#37; de los estudiantes&#46; El estr&#233;s fue reportado solo por el 7&#44;7&#37; de los estudiantes&#46; Los estudiantes del rango de estr&#233;s postraum&#225;tico anormal superaron la mitad de los participantes &#40;61&#44;3&#37;&#41;&#46; Por &#250;ltimo&#44; nuestros resultados reflejaron que solo una minor&#237;a de estudiantes obtuvieron una puntuaci&#243;n alta de resiliencia &#40;13&#44;8&#37;&#41;&#46; Estos sorprendentes hallazgos en cuanto a las condiciones de salud mental de los estudiantes de enfermer&#237;a pueden explicarse por dos motivos&#58; bien existi&#243; una falta de inter&#233;s por la salud mental como componente esencial del cuidado&#44; que no deber&#237;a menospreciarse en favor de los procedimientos m&#233;dicos y quir&#250;rgicos&#44; o bien existi&#243; una falta de concienciaci&#243;n entre los estudiantes universitarios&#44; y en especial entre aquellos de las profesiones sanitarias&#44; sobre la necesidad de prepararse para los desastres naturales&#46; De hecho&#44; el estigma de la salud mental impide a las personas la b&#250;squeda de cuidados en esta materia<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">27</span></a>&#46; Las demandas de mayor presi&#243;n en una situaci&#243;n de terremoto son la atenci&#243;n m&#233;dica inmediata&#44; el cuidado f&#237;sico y los suministros urgentes<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">9</span></a>&#46; En situaciones desastrosas como los terremotos&#44; se priorizan la atenci&#243;n m&#233;dica y f&#237;sica inmediatas&#44; junto con los suministros urgentes<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">9</span></a>&#46; Sin embargo&#44; es igualmente esencial garantizar el apoyo en materia de salud mental para los primeros respondedores y las poblaciones afectadas&#46; Por ejemplo&#44; en Croacia&#44; un equipo comunitario proporcion&#243; de manera efectiva servicios accesibles tras el desastre&#44; ayudando a los individuos con enfermedades mentales graves<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">28</span></a>&#46; A pesar de los esfuerzos en Hait&#237; para integrar el apoyo en materia de salud mental&#44; existe una necesidad de un avance ulterior&#44; ya que las pr&#225;cticas de los profesionales sanitarios primarios siguen inalteradas y los sistemas de orientaci&#243;n siguen estando en fase inicial<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">6</span></a>&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">De manera similar a los hallazgos de otro estudio realizado tras el terremoto de Nueva Zelanda de 2010<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">14</span></a>&#44; la correlaci&#243;n entre las diferentes escalas fue positiva&#44; exceptuando la escala de evaluaci&#243;n de la resiliencia&#44; que tuvo una correlaci&#243;n negativa con todas las escalas&#46; De hecho&#44; este es un resultado coherente&#44; ya que tener puntuaciones altas de PCL-C y DASS-21 es consistente con una puntuaci&#243;n baja de resiliencia &#40;CD-RISC&#41;&#44; lo cual indic&#243; en ambos casos una alteraci&#243;n del estado psicol&#243;gico&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Los resultados reflejaron que la escala DAS&#44; y m&#225;s espec&#237;ficamente la escala de ansiedad&#44; se correlacionaron negativamente con la edad&#44; lo cual significa que los estudiantes de mayor edad obtuvieron puntuaciones m&#225;s bajas&#44; es decir&#44; valores normales de ansiedad&#46; De hecho&#44; la edad es un supuesto inherente de que la resiliencia puede incrementarse con la edad<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">14</span></a>&#44; a pesar de que en una revisi&#243;n de la literatura sobre el terremoto de Canterbury existen brechas relativas en cuanto al conocimiento de los resultados a largo plazo para las poblaciones de beb&#233;s y personas mayores<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">7</span></a>&#46; Adem&#225;s&#44; en el presente estudio&#44; el sexo femenino obtuvo mayores puntuaciones en las escalas de ansiedad y estr&#233;s&#46; Dichos resultados corroboraron un estudio que mostr&#243; que la necesidad de apoyo en materia de salud mental a largo plazo&#44; transcurridos dos a&#241;os del terremoto&#44; fue m&#225;s alta en mujeres que en hombres<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">29</span></a>&#46; Esto puede explicarse por las presiones culturales y sociales espec&#237;ficas de las mujeres en los contextos &#225;rabes&#44; que incluyen altas expectativas en t&#233;rminos de responsabilidades familiares y dom&#233;sticas&#44; adem&#225;s de las demandas acad&#233;micas y profesionales&#44; pudiendo contribuir a unos mayores niveles de estr&#233;s y ansiedad&#46; Los resultados destacaron tambi&#233;n que los estudiantes que viven con sus familias tuvieron una puntuaci&#243;n m&#225;s alta de resiliencia que el resto de los estudiantes&#46; De hecho&#44; la cohesi&#243;n social en las secuelas del terremoto redujo la hospitalizaci&#243;n psiqui&#225;trica y los casos de suicidio en Ecuador<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">8</span></a>&#46; La escala de estr&#233;s postraum&#225;tico solo se vio afectada por el da&#241;o material&#46; De igual modo&#44; otro hallazgo indic&#243; que aquellos que hab&#237;an experimentado m&#225;s la destrucci&#243;n grave de su vivienda&#44; requiriendo el abandono de su casa&#44; necesitaron m&#225;s apoyo de salud mental a largo plazo<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">29</span></a>&#46; Perder a un familiar en el terremoto tambi&#233;n afect&#243; significativamente a la escala DASS&#46; Esto puede explicarse porque no hab&#237;an transcurrido seis meses en el periodo de la encuesta&#46; La p&#233;rdida de familiares o amigos no estuvo asociada a depresi&#243;n transcurridos tres a&#241;os del desastre&#46; Los supervivientes del terremoto de 2011 parecen haberse recuperado de la p&#233;rdida de sus seres queridos&#46; Por contra&#44; la p&#233;rdida material estuvo asociada a un impacto negativo persistente en la salud mental<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">30</span></a>&#46; En resumen&#44; recientemente se encontraron resultados casi similares en Siria&#44; lo cual refleja que los peores resultados de salud mental estuvieron asociados al sexo femenino&#44; la solter&#237;a&#44; la juventud&#44; y el da&#241;o o destrucci&#243;n de la vivienda<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">10</span></a>&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Adem&#225;s&#44; influy&#243; el curso de estudio&#44; siendo los estudiantes de 3<span class="elsevierStyleSup">er</span> grado &#40;como curso final para t&#237;tulo de enfermer&#237;a&#41; los que obtuvieron una mediana m&#225;s alta que los estudiantes de otros grados en todas las subescalas de depresi&#243;n&#44; estr&#233;s y ansiedad de DAS&#46; Esto puede explicarse porque los estudiantes de 3<span class="elsevierStyleSup">er</span> curso han contribuido a la gesti&#243;n de casos en los hospitales y las instituciones sanitarias&#46; De acuerdo con diversos estudios&#44; la experiencia de los profesionales sanitarios en el manejo de los terremotos afecta sustancialmente a su salud mental<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">13&#44;14</span></a>&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Por &#250;ltimo&#44; este estudio no estableci&#243; ninguna asociaci&#243;n entre la salud mental de los estudiantes de enfermer&#237;a y la asistencia al fen&#243;meno&#44; lo cual puede explicarse por el peque&#241;o n&#250;mero que no asisti&#243; al terremoto ni sinti&#243; el mismo&#44; lo cual afect&#243; a la variabilidad de este factor en el presente estudio&#46; Tampoco existi&#243; asociaci&#243;n entre la salud mental de los estudiantes de enfermer&#237;a y el hecho de vivir cerca del foco del terremoto&#44; contrariamente a otro estudio que demostr&#243; que un gran n&#250;mero de participantes de regiones gravemente da&#241;adas report&#243; s&#237;ntomas depresivos en comparaci&#243;n con las regiones que sufrieron da&#241;os moderados y leves&#46; Esto puede explicarse por las personas que han visto u o&#237;do situaciones tr&#225;gicas&#44; reflejando peores resultados de salud mental<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">10</span></a>&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Por tanto&#44; adem&#225;s de realizar evaluaciones de salud mental antes y despu&#233;s de los sucesos&#44; los profesionales sanitarios actuales y futuros&#44; de los cuales se espera que aporten alivio frente al desastre&#44; deben someterse tambi&#233;n a la formaci&#243;n necesaria en cuanto a manejo del estr&#233;s&#44; resiliencia psicol&#243;gica y expresividad emocional<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">13</span></a>&#46; Se enfatiza la necesidad de supervisar las necesidades de los estudiantes antes y despu&#233;s de los desastres&#46; Es urgente que las instituciones de educaci&#243;n superior prioricen la salud mental de los estudiantes&#44; a fin de garantizar su &#233;xito acad&#233;mico&#44; y animar las intervenciones proactivas tales como la formaci&#243;n de estudiantes y personal en t&#233;cnicas de construcci&#243;n de resiliencia<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">14</span></a>&#46; De igual modo&#44; las organizaciones no gubernamentales y la oficina estatal de la Organizaci&#243;n Mundial de la Salud deber&#225;n seguir apoyando la salud mental de los trabajadores sanitarios y&#44; en particular&#44; en momentos de desastre&#44; como en Nepal<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">31</span></a>&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conclusi&#243;n</span><p id="par0135" class="elsevierStylePara elsevierViewall">Este estudio destac&#243; la prevalencia de los trastornos de salud mental entre los estudiantes de enfermer&#237;a&#44; adem&#225;s de la disminuci&#243;n de la capacidad de resiliencia&#44; y las altas puntuaciones de depresi&#243;n&#44; ansiedad y estr&#233;s postraum&#225;tico transcurridos seis meses del <span class="elsevierStyleItalic">shock</span>&#46; La edad&#44; el sexo&#44; el respaldo de la familia y la p&#233;rdida de un familiar&#44; as&#237; como las p&#233;rdidas materiales durante este desastre son factores que repercutieron en la salud psicol&#243;gica de dichos estudiantes en Marruecos&#44; lo cual destaca la necesidad de tener en cuenta la especificidad de la poblaci&#243;n expuesta a estos factores y su susceptibilidad al cuidado posterior al terremoto&#46; Por otro lado&#44; la respuesta tras el terremoto y el desastre en general deben acelerar el progreso del manejo emocional en las universidades sanitarias&#46; Por tanto&#44; nuestro estudio sugiere la importancia de invertir en recursos de salud mental adaptados a las necesidades &#250;nicas de los estudiantes de enfermer&#237;a&#46; Ello incluye intervenciones espec&#237;ficas&#44; incremento del acceso a los servicios de asesoramiento&#44; y mejora de la educaci&#243;n en salud mental dentro del curr&#237;culo de enfermer&#237;a&#46; Adem&#225;s&#44; existe una necesidad de investigaci&#243;n adicional&#44; para comprender los factores subyacentes que contribuyen a los retos sobre salud mental entre los estudiantes de enfermer&#237;a e informar sobre estrategias basadas en la evidencia para la intervenci&#243;n y soporte&#46; Por &#250;ltimo&#44; para la investigaci&#243;n futura&#44; podr&#237;a realizarse una investigaci&#243;n longitudinal como estudio de casos y controles&#44; para respaldar los resultados de este estudio&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Financiaci&#243;n</span><p id="par0140" class="elsevierStylePara elsevierViewall">No se ha recibido financiaci&#243;n para este trabajo&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Contribuciones de los autores</span><p id="par0145" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Amane Mounia</span>&#58; Realiz&#243; la encuesta&#44; analiz&#243; e interpret&#243; los datos&#44; y redact&#243; el art&#237;culo&#46; <span class="elsevierStyleBold">Boussaa Samia&#58;</span> Ide&#243; y dise&#241;&#243; la investigaci&#243;n&#44; redact&#243; y revis&#243; el documento&#46; <span class="elsevierStyleBold">Hachoumi Nadia&#58;</span> Redact&#243; y revis&#243; el documento&#46; <span class="elsevierStyleBold">Laabidi Rkia&#44; Mazzi Loubna&#44; Yakini Souad&#44; Loulidi Sokaina y Jbari Siham&#58;</span> Recopilaron los datos&#46; <span class="elsevierStyleBold">Mourid El Hassan</span> Revis&#243; el documento&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Conflicto de intereses</span><p id="par0150" class="elsevierStylePara elsevierViewall">Los autores declaran la ausencia de conflicto de intereses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Adem&#225;s del impacto econ&#243;mico y social&#44; los problemas de salud mental son una de las necesidades sanitarias durante cat&#225;strofes naturales como los terremotos&#46; Por ello&#44; la vigilancia de las variables de salud mental es crucial para la planificaci&#243;n de la salud p&#250;blica&#46; Los estudiantes de enfermer&#237;a&#44; como estudiantes profesionales&#44; pueden ser particularmente vulnerables a los efectos adversos sobre la salud mental despu&#233;s de un terremoto debido a su papel potencial en la respuesta de emergencia y los desaf&#237;os asociados a la prestaci&#243;n de atenci&#243;n m&#233;dica en condiciones de crisis&#46; El objetivo de esta investigaci&#243;n fue evaluar la salud mental de los estudiantes transcurridos seis meses del terremoto de Marruecos y los factores asociados&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se realiz&#243; una encuesta transversal a estudiantes de enfermer&#237;a en marzo de 2024&#44; seis meses despu&#233;s del terremoto de Marruecos a 261 estudiantes utilizando el m&#233;todo de muestreo por clases&#46; Se utilizaron tres medidas psicom&#233;tricas validadas&#58; <span class="elsevierStyleItalic">Post-traumatic Stress Disorder Checklist-Civilian</span> &#40;PCL-C&#41;&#44; <span class="elsevierStyleItalic">Depression&#44; Anxiety and Stress Scale</span> &#40;DASS-21&#41; y <span class="elsevierStyleItalic">Connor-Davidson Resilience Scale</span> &#40;CD-RISC&#41; para evaluar la salud mental de los estudiantes de enfermer&#237;a tras el terremoto de Marruecos&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La ansiedad&#44; la depresi&#243;n&#44; el estr&#233;s y el rango anormal de estr&#233;s postraum&#225;tico estaban presentes respectivamente en el 44&#44;8&#44; 37&#44;1&#44; 7&#44;7 y 61&#44;3&#37; de los participantes&#46; Sin embargo&#44; una minor&#237;a de estudiantes obtuvo la puntuaci&#243;n de resiliencia alta &#40;13&#44;8&#37;&#41;&#46; Los resultados mostraron que la escala DASS correlacionaba negativamente con la edad &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;034&#41;&#46; Adem&#225;s&#44; el g&#233;nero femenino&#44; los estudiantes de 3<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleSup">er</span> grado &#40;como &#250;ltimo curso de la diplomatura de enfermer&#237;a&#41; y los que hab&#237;an perdido a un familiar en la cat&#225;strofe natural obtuvieron medianas m&#225;s altas con una diferencia significativa en la puntuaci&#243;n de la escala DASS &#40;p &#706; 0&#44;05&#41;&#46; La escala de estr&#233;s postraum&#225;tico solo se vio afectada por los da&#241;os materiales &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;044&#41;&#46; Sin embargo&#44; el alto nivel de las puntuaciones de resiliencia fue obtenido significativamente por los estudiantes que viv&#237;an con sus familias&#46; Por el contrario&#44; no se observ&#243; ninguna asociaci&#243;n entre la salud mental de los estudiantes de enfermer&#237;a y la asistencia al fen&#243;meno o el hecho de vivir cerca de los focos del terremoto&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Este estudio ha demostrado la necesidad crucial de formar al personal sanitario en la gesti&#243;n de las emociones en caso de cat&#225;strofe natural y de poner en marcha iniciativas <span class="elsevierStyleItalic">a priori</span>&#44; sobre todo en lo que respecta a la salud mental de los estudiantes de las universidades sanitarias&#44; con el fin de prepararlos psicol&#243;gicamente para cualquier intervenci&#243;n en caso de alerta&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objetivo"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "M&#233;todo"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">In addition to the economic and social impact&#44; mental health issues are one of health needs during natural disaster such as earthquake&#46; Thus&#44; surveillance for mental health variables is crucial for public health planning&#46; Nursing students as professional students may be particularly vulnerable to adverse mental health effects after an earthquake because of their potential role in emergency response and the challenges associated with providing medical care in crisis conditions&#46; The aim of this research was to assess the mental health of students after six months of the Moroccan earthquake and associated factors&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A cross-sectional survey of student nurses was conducted on March 2024&#59; six months after the Moroccan earthquake in front to 261 students using class sampling method&#46; Three validated psychometric measures&#44; Post-Traumatic Stress Disorder &#40;PCL-<span class="elsevierStyleSmallCaps">C</span>&#41;&#44; Depression&#44; Anxiety and Stress Scale &#40;DASS-21&#41;&#44; and The Connor-Davidson Resilience Scale &#40;CD-RISC&#41; were used to assess the nursing student mental health after Moroccan earthquake&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Anxiety&#44; Depression&#44; Stress and abnormal post-traumatic stress rank was present respectively in 44&#44;8&#37;&#44; 37&#44;1&#37;&#44; 7&#44;7&#37;&#44; 61&#44;3&#37; of participants&#46; However&#44; a minority of students obtained the high resilience score &#40;13&#44;8&#37;&#41;&#46; The results showed that the DAS scale correlated negatively with age &#40;p&#61;0&#44;034&#41;&#46; Furthermore&#44; the female gender&#44; 3<span class="elsevierStyleHsp" style=""></span>rd grade students &#40;as final year for the nursing diploma&#41; and those who had lost a family member in the natural disaster obtained higher medians with a significant difference in the DAS scale score &#40;p&#706;0&#46;05&#41;&#46; The post-traumatic stress scale was only affected by material damage &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;044&#41;&#46; However&#44; the high level of scores resilience obtained significantly for students living with their families&#46; In contrast&#44; no association between the mental health of nursing students and attending the phenomenon or living near earthquake foci&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">This study has demonstrated the crucial need to train healthcare providers in emotion management in the event of a natural disaster&#44; and to launch a priori initiatives&#44; particularly with regard to the mental health of students in health universities&#44; in order to prepare them psychologically for any intervention in the case of an alert&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objective"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Method"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusion"
          ]
        ]
      ]
    ]
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      0 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabla 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Caracter&#237;sticas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Modalidades&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Frecuencia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Porcentaje&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sexo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Var&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mujer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">209&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Procedencia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Zona del desastre &#40;epicentro del terremoto&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Otra zona&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">183&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Residencia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Familiar&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">189&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Coalquiler&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Otros&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Especialidad&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Atenci&#243;n enfermera&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">215&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">82&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Asistencia social&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Rehabilitaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enfermer&#237;a t&#233;cnica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Niveles&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Primer a&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">118&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Segundo a&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">113&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tercer a&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Asisti&#243; al terremoto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#205;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">253&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">96&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Perdi&#243; un familiar&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#205;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">258&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">98&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Da&#241;o material&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#205;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">76&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3610957.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas de la poblaci&#243;n de estudio &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>261&#41;</p>"
        ]
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      1 => array:8 [
        "identificador" => "tbl0010"
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        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabla "
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          ]
        ]
        "tabla" => array:1 [
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            0 => array:2 [
              "tabla" => array:1 [
                0 => """
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Escalas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Descripci&#243;n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Frecuencia &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Media&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mediana&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Alfa de Cronbach&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Kolmog&#243;rov-Smirnov&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
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                  \t\t\t\t">Depresi&#243;n</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Normal</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">164 &#40;62&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Leve</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61 &#40;19&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Moderada</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46 &#40;17&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ansiedad</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Normal</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Extremadamente grave</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1 &#40;0&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " rowspan="3" align="left" valign="\n
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                  \t\t\t\t">Estr&#233;s</td><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Normal</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#40;PCL&#41; <span class="elsevierStyleItalic">Checklist</span></td><td class="td" title="\n
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                  \t\t\t\t">Rango normal&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Rango anormal&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">CD-RISC-10</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Nivel bajo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">225 &#40;86&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;039&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Nivel alto&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">36 &#40;13&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DASS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;92&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Depresi&#243;n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Estr&#233;s&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">0&#44;916<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;&#42;</a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">-0&#44;161<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;&#42;</a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">0&#44;544<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;&#42;</a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;754<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;&#42;</a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;901<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">-0&#44;136<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;512<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;&#42;</a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Estr&#233;s&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;923<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-0&#44;179<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;555<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Escala DAS total&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-0&#44;174<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;588<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;&#42;</a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">-0&#44;130<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;PCL&#41; Lista de comprobaci&#243;n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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        "tabla" => array:2 [
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                  <table border="0" frame="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Caracter&#237;sticas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Estr&#233;sMediana &#40;RIC&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Escala DASMediana &#40;RIC&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#40;PCL&#41; <span class="elsevierStyleItalic">Checklist</span>Mediana &#40;RIC&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CD-RISC-10Mediana &#40;RIC&#41;&nbsp;\t\t\t\t\t\t\n
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          "es" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Factores asociados a la salud mental de los estudiantes de enfermer&#237;a</p>"
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          "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">&#191;Qu&#233; se conoce&#63;</span><p id="par0005" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#8226;</span><p id="par0010" class="elsevierStylePara elsevierViewall">Adem&#225;s del impacto econ&#243;mico y social&#44; las cuestiones de salud mental son una de las necesidades sanitarias durante los desastres naturales tales como un terremoto&#46;</p></li></ul></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">&#191;Qu&#233; aporta&#63;</span><p id="par0015" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#8226;</span><p id="par0020" class="elsevierStylePara elsevierViewall">Los participantes presentaron ansiedad&#44; depresi&#243;n&#44; estr&#233;s y rango anormal de estr&#233;s postraum&#225;tico&#46; Sin embargo&#44; una minor&#237;a de estudiantes obtuvo la puntuaci&#243;n de resiliencia alta&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#8226;</span><p id="par0025" class="elsevierStylePara elsevierViewall">La escala de estr&#233;s postraum&#225;tico se vio &#250;nicamente afectada por el da&#241;o material&#46; Sin embargo&#44; el alto nivel de las puntuaciones de resiliencia fue obtenido de manera significativa por los estudiantes que viv&#237;an con sus familias&#46;</p></li></ul></p></span></span>"
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                    0 => array:2 [
                      "titulo" => "A probabilistic seismic hazard model for North Africa"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "V&#46; Poggi"
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                            4 => "R&#46; Gee"
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                      "doi" => "10.1007/s10518-020-00820-4"
                      "Revista" => array:5 [
                        "tituloSerie" => "Bull&#46; Earthq&#46; Eng&#46;"
                        "fecha" => "2020"
                        "volumen" => "18"
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Información del artículo
ISSN: 11308621
Idioma original: Español
DOI:10.1016/j.enfcli.2024.06.010
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2024 Agosto 1 2 3

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