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Escala de preocupación por el contagio de la COVID-19 en personal de la salud peruano
Scale of Concern about COVID-19 Infection in Peruvian Health Care Workers
Renzo Felipe Esteban-Carranzaa,
Autor para correspondencia
rcarranza@usil.edu.pe

Autor para correspondencia.
, Oscar Javier Mamani-Benitob, J. Franco Rodriguez-Alarconc,d, Ibraín Enrique Corrales-Reyese,f, Rosa Farfán-Solísg,h
a Universidad San Ignacio de Loyola, Lima, Perú
b Universidad Nacional de San Agustín de Arequipa, Arequipa, Perú
c Asociación Médica de Investigación y Servicios en Salud (AMISS), Lima, Perú
d Facultad de Medicina Humana Manuel Huaman Guerrero, Universidad Ricardo Palma, Lima, Perú
e Universidad Señor de Sipán, Chiclayo, Perú
f Hospital General Universitario Carlos Manuel de Céspedes, Universidad de Ciencias Médicas de Granma, Granma, Cuba
g Universidad Peruana Unión, Juliaca, Perú
h Dirección Regional de Salud, Puno, Perú
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adecuados&#44; los trabajadores de salud que atienden a pacientes infectados pueden contagiarse con el virus SARS-CoV-2<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">4</span></a>&#46; Tal como revelan algunos reportes de China&#44; esta poblaci&#243;n tambi&#233;n viene afrontando repercusiones en su salud mental a causa de factores como la sobrecarga de trabajo&#44; que los vulnera emocionalmente<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">5</span></a>&#46; Por ello&#44; en gran parte de los hospitales de la ciudad china de Wuhan se tuvo que establecer un sistema de turnos de trabajo para que el personal de salud descansara y evitara estar constantemente expuesto<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">6</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Es frente a esta situaci&#243;n que surgi&#243; la necesidad de que la exposici&#243;n ocupacional de este tipo de poblaci&#243;n tuviera que abordarse con precisi&#243;n&#59; por ello&#44; una de las estrategias para el control y la prevenci&#243;n de esta enfermedad en instituciones de salud es la vigilancia y el tratamiento del personal expuesto<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">7</span></a>&#46; Sin embargo&#44; factores como equipos de protecci&#243;n inadecuados&#44; pruebas de diagn&#243;stico insuficientes&#44; sobrecarga de trabajo y exposici&#243;n prolongada a pacientes infectados son causa de riesgo de contagio<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">8&#44;9</span></a>&#46; A modo de ejemplo de la gravedad de las circunstancias&#44; iniciada la pandemia escasearon las mascarillas respiratorias N95 de un solo uso&#44; lo cual llevaba al reciclaje para ampliar la validez limitada de los proveedores y las instalaciones de atenci&#243;n m&#233;dica<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">10</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">En consecuencia&#44; esta crisis global ha impulsado la preocupaci&#243;n por el contagio de la COVID-19 entre los trabajadores de la salud&#44; pues lo que menos desean es perjudicar a los compa&#241;eros de labor&#44; familiares cercanos y amigos&#46; Esto se ha evidenciado en investigaciones que han hallado que la preocupaci&#243;n m&#225;s frecuente entre el personal sanitario es transmitir la infecci&#243;n a familiares y amigos&#44; m&#225;s que a ellos mismos&#44; lo que les genera estr&#233;s y ansiedad<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">11</span></a>&#46; A pesar de estas circunstancias&#44; se observa en diversos contextos que el personal de salud contin&#250;a realizando sus funciones aun cuando se encuentran en un persistente modo de supervivencia para proteger a todos los que los rodean<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">12</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">En este escenario en Per&#250;&#44; algunos investigadores han dise&#241;ado&#44; adaptado y validado pruebas para evaluar aspectos importantes del impacto de la COVID-19&#46; As&#237;&#44; se ha creado una escala breve para medir el nivel de conocimientos b&#225;sicos acerca del coronavirus &#40;KNOW-P-COVID-19&#41;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">13</span></a> compuesta por 9&#160;&#237;tems distribuidos en 2&#160;dimensiones&#46; Otros investigadores han dise&#241;ado una escala para evaluar el fatalismo ante la posibilidad del contagio de la enfermedad &#40;F-COVID-19&#41;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">14</span></a>&#44; que qued&#243; compuesta por 8&#160;&#237;tems distribuidos en 2&#160;factores&#46; Asimismo ha aparecido una escala para medir el miedo y la magnitud del problema &#40;MED-COVID-19&#41;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">15</span></a> compuesta por 13&#160;&#237;tems distribuidos en 3&#160;factores&#46; Por &#250;ltimo&#44; Ruiz Mamani et al&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">16</span></a> han validado una escala de preocupaci&#243;n por el contagio para adultos peruanos&#44; la cual consta de 6&#160;&#237;tems en 1&#160;solo factor &#40;EPCov-19&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Por lo visto hasta este punto&#44; se ha hecho &#233;nfasis en el dise&#241;o de instrumentos para la poblaci&#243;n general&#59; sin embargo&#44; no existen pruebas espec&#237;ficas para la sanitaria&#44; lo cual constituye la principal motivaci&#243;n para emprender esta investigaci&#243;n en virtud de llenar este vac&#237;o en la literatura cient&#237;fica&#46; Adem&#225;s&#44; aunque los trabajadores sanitarios son responsables de gestionar la crisis en los centros de atenci&#243;n&#44; no son inmunes a las consecuencias psicol&#243;gicas&#44; de ah&#237; la necesidad de desarrollar instrumentos para evaluar la preocupaci&#243;n por el contagio de la COVID-19 y de esta forma generar evidencias sobre el tema&#46; Por lo tanto&#44; el objetivo de la presente investigaci&#243;n es dise&#241;ar y analizar las evidencias de validez de contenido&#44; estructura interna y confiabilidad de una medida de preocupaci&#243;n por el contagio de COVID-19 en personal de salud peruano&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">M&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Dise&#241;o del estudio y participantes</span><p id="par0035" class="elsevierStylePara elsevierViewall">Se realiz&#243; un estudio de tipo instrumental de corte transversal<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">17</span></a>&#46; El muestreo utilizado fue no probabil&#237;stico&#44; intencional y por criterios&#46; Se incluy&#243; a 321 profesionales de ambos sexos &#40;78 varones y 243 mujeres&#59; edad&#44; 22-64 &#91;38&#44;12<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#44;61&#93; a&#241;os&#41; del &#225;rea de la salud &#40;Medicina&#44; Odontolog&#237;a&#44; Enfermer&#237;a&#44; Nutrici&#243;n&#44; Psicolog&#237;a&#44; Obstetricia&#41; de la Regi&#243;n Puno&#44; sur del Per&#250;&#44; que desearon participar&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Selecci&#243;n inicial de los &#237;tems</span><p id="par0040" class="elsevierStylePara elsevierViewall">Se realiz&#243; una revisi&#243;n de la literatura en diferentes fuentes de informaci&#243;n cient&#237;fica&#58; Google Acad&#233;mico&#44; PubMed&#47;MEDLINE y SciELO&#44; con los siguientes t&#233;rminos de b&#250;squeda&#58; &#8220;2019-nCoV&#8221;&#44; &#8220;COVID-19&#8221;&#44; &#8220;SARS-CoV-2&#8221;&#44; &#8220;2019 novel coronavirus&#8221;&#44; &#8220;coronavirus disease 2019&#8221;&#44; &#8220;novel coronavirus&#8221;&#44; &#8220;new coronavirus&#8221;&#44; &#8220;coronavirus 2019&#8221;&#44; &#8220;concern&#8221;&#44; &#8220;infection&#8221; y &#8220;health-care workers&#8221;&#46; Luego se redact&#243; el primer borrador del instrumento&#44; el cual fue revisado y aprobado por todos los autores&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Informaci&#243;n t&#233;cnica y metodol&#243;gica</span><p id="par0045" class="elsevierStylePara elsevierViewall">La escala de preocupaci&#243;n ante la posibilidad de contagio de la COVID-19 &#40;EPPC&#8211;Cov19&#41; mide el estado emocional que implica temor&#44; intranquilidad&#44; angustia e inmovilidad que se inician ante sucesos desconocidos y negativos&#44; construido por el sistema cognitivo&#59; en otras palabras&#44; la reacci&#243;n psicol&#243;gica natural frente a lo desconocido&#44; como es el caso de la COVID-19&#44; que es una enfermedad nueva que causa incertidumbre en los trabajadores del &#225;mbito sanitario&#46; Est&#225; conformada por 8&#160;&#237;tems con 5&#160;opciones de respuesta en una escala Likert de igual cantidad de puntos &#40;1<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>nunca&#59; 5<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>siempre&#41;&#44; y la puntuaci&#243;n final es la suma de todos los &#237;tems&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Validaci&#243;n</span><p id="par0050" class="elsevierStylePara elsevierViewall">Se analiz&#243; la evidencia de la validez de contenido de la escala y se solicit&#243; el juicio de 8 expertos &#40;diferentes de los desarrolladores de la escala&#41; que consideraron 4&#160;criterios para la evaluaci&#243;n de los &#237;tems &#40;desde 0<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>nada relevante&#47;representativo&#47;claro hasta 3<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>totalmente relevante&#47;representativo&#47;claro&#41;&#46; Estos profesionales expertos son m&#233;dicos epidemi&#243;logos e intensivitas&#44; psiquiatras&#44; psic&#243;logos cl&#237;nicos y enfermeras intensivistas&#46; Para cuantificar el grado de relevancia&#44; representatividad y claridad&#44; se emple&#243; el coeficiente V de Aiken y sus intervalos de confianza del 95&#37; &#40;IC95&#37;&#41;&#46; Una V &#8805;&#160;0&#44;70 con IC95&#37; &#8805;&#160;0&#44;59 indica una valoraci&#243;n positiva del reactivo<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">18</span></a>&#46; Luego se procedi&#243; a la aplicaci&#243;n de la encuesta <span class="elsevierStyleItalic">online</span> mediante Google Form&#46; Antes de la aplicaci&#243;n&#44; se coment&#243; a los participantes el objetivo de la investigaci&#243;n y se solicit&#243; el consentimiento informado&#46; Se consider&#243; la participaci&#243;n voluntaria y an&#243;nima&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">An&#225;lisis de datos</span><p id="par0055" class="elsevierStylePara elsevierViewall">El an&#225;lisis se realiz&#243; en varias etapas&#46; En la primera se analizaron los estad&#237;sticos descriptivos &#40;media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>desviaci&#243;n est&#225;ndar&#44; asimetr&#237;a y curtosis&#41; de los 8&#160;&#237;tems de la escala&#44; el valor que se tuvo en cuenta para la asimetr&#237;a y la curtosis fue<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;5 de acuerdo con P&#233;rez et al&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">19</span></a>&#46; En la segunda fase&#44; se realiz&#243; un an&#225;lisis factorial exploratorio &#40;AFE&#41; siguiendo los criterios de Kaplan et al&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">20</span></a>&#44; considerando el coeficiente Kaiser-Meyer-Olkin &#40;KMO&#41; y la prueba de Bartlett&#46; El an&#225;lisis paralelo revel&#243; la existencia de un solo factor&#59; asimismo&#44; el m&#233;todo de estimaci&#243;n fue de m&#237;nimos cuadrados no ponderado con rotaci&#243;n promin<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">21</span></a>&#46; En la tercera etapa&#44; se ejecut&#243; un an&#225;lisis factorial confirmatorio &#40;AFC&#41; y se consider&#243; el modelamiento de ecuaciones estructurales &#40;SEM&#41;&#46; Para evaluar las medidas de bondad de ajuste&#44; se utiliz&#243; el &#237;ndice de bondad de ajuste &#40;GFI&#41;&#44; el &#237;ndice ajustado de bondad de ajuste &#40;AGFI&#41;&#44; el &#237;ndice de bondad de ajuste parsimonioso &#40;PGFI&#41;&#44; el &#237;ndice normalizado de ajuste &#40;NFI&#41;&#44; el &#237;ndice de ajuste relativo &#40;RFI&#41;&#44; &#237;ndice de ajuste incremental &#40;IFI&#41;&#44; el &#237;ndice de Tucker-Lewis Index &#40;TLI&#41; y el &#237;ndice de ajuste comparativo &#40;CFI&#41;&#46; Tambi&#233;n se consideraron los par&#225;metros para el error cuadr&#225;tico medio de aproximaci&#243;n &#40;RMSEA&#41; y el &#237;ndice de error cuadr&#225;tico medio &#40;RMR&#41;&#44; siguiendo los criterios recomendados por Hu et al&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">22</span></a>&#44; quienes se&#241;alan que GFI&#44; CFI&#44; TLI y NFI deber&#237;an ser<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;9 y el RMSEA y el SRMR&#44;<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;08&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Para los an&#225;lisis descriptivos y el AFE&#44; se utiliz&#243; el programa FACTOR Analysis versi&#243;n 10&#44;1&#46; Para ejecutar el AFC&#44; se emple&#243; el <span class="elsevierStyleItalic">software</span> estad&#237;stico AMOS versi&#243;n 21&#44; y para calcular la confiabilidad de la escala&#44; el programa estad&#237;stico SPSS versi&#243;n 25&#46;0 y sus respectivos intervalos de confianza<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">23</span></a>&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Resultados</span><p id="par0065" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> muestra que todos los &#237;tems recibieron una evaluaci&#243;n favorable de los expertos &#40;V<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;70&#41;&#46; En cuanto a la relevancia&#44; se encontr&#243; que los &#237;tems 4 y 5 son los m&#225;s importantes y representativos &#40;V<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;00&#59; IC95&#37;&#44; 0&#44;86-1&#44;00&#46; Con respecto a los &#237;tems m&#225;s entendibles &#40;claros&#41;&#44; el &#237;tem 5 y 8 fueron los mejor evaluados &#40;V<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;00&#59; IC95&#37;&#44; 0&#44;86-1&#44;00&#41;&#46; Asimismo&#44; se observa que los valores del l&#237;mite inferior &#40;Li&#41; del IC95&#37; son adecuados y todos los valores del coeficiente V fueron estad&#237;sticamente significativos&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">An&#225;lisis preliminar de los &#237;tems</span><p id="par0070" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> muestra la media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>desviaci&#243;n est&#225;ndar&#44; la asimetr&#237;a y la curtosis de los 8&#160;&#237;tems de la EPPC-Cov19&#46; Se aprecia que el &#237;tem 5 tiene el mayor puntaje promedio y la mayor dispersi&#243;n &#40;3&#44;68<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;17&#41;&#46; Los valores de asimetr&#237;a y curtosis de los 8&#160;&#237;tems de la escala no exceden el intervalo<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;5<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">19</span></a>&#46; Asimismo&#44; las correlaciones entre los &#237;tems fueron significativas &#40;&#62;&#160;0&#44;40&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">An&#225;lisis factorial exploratorio</span><p id="par0075" class="elsevierStylePara elsevierViewall">En primera instancia&#44; se analizaron los &#237;ndices de adecuaci&#243;n muestral&#44; el valor de Kaiser-Meyer-Olkin &#40;KMO<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;917&#41; y el test de Bartlett &#40;1&#46;555&#44;4&#59; gl<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>28&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; fueron muy buenos&#44; lo indica que es adecuado realizar el AFE en la muestra estudiada&#46; Se utiliz&#243; el m&#233;todo de m&#237;nimos cuadrados no ponderados&#44; y el an&#225;lisis paralelo indic&#243; que los 8&#160;&#237;tems subyacen en un solo factor&#46; El factor obtenido explica el 63&#44;89&#37; de la varianza total de la prueba y sus cargas factoriales oscilan entre 0&#44;599 y 0&#44;864 &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">An&#225;lisis factorial confirmatorio</span><p id="par0080" class="elsevierStylePara elsevierViewall">Para analizar la estructura interna de la escala&#44; se realiz&#243; un AFC donde se cargaron los 8&#160;&#237;tems de la EPPC-Cov19 en una sola variable latente&#59; los resultados del modelo original mostraron que la bondad de ajuste era deficiente&#44; por lo que&#44; a trav&#233;s de la t&#233;cnica de modificaci&#243;n de &#237;ndices&#44; se eliminaron los &#237;tems 2 y 3 y qued&#243; un modelo &#243;ptimo&#46; Los &#237;ndices de bondad de ajuste muestran que el modelo propuesto es adecuado &#40;&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>27&#44;183&#59; df<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>9&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#59; RMR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;036&#59; GFI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;971&#59; AGFI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;931&#59; PGFI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;416&#59; NFI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;971&#59; RFI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;951&#59; IFI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;980&#59; TLI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;967&#59; CFI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;980&#44; y RMSEA<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;079&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46; La confiabilidad de la prueba se calcul&#243; con el coeficiente alfa de Cronbach &#40;&#945;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;865&#59; IC95&#37;&#44; 0&#44;83-0&#44;89&#41;&#46; En s&#237;ntesis&#44; el modelo de 6&#160;&#237;tems en 1&#160;solo factor es satisfactorio &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Discusi&#243;n</span><p id="par0085" class="elsevierStylePara elsevierViewall">Durante los meses de emergencia sanitaria&#44; las v&#237;ctimas del SARS-CoV-2 no solo han sido poblaci&#243;n general&#44; sino que esta enfermedad se ha llevado consigo la vida de polic&#237;as&#44; funcionarios p&#250;blicos y&#44; sobre todo&#44; personal de salud&#46; Hasta el momento de la redacci&#243;n de este estudio&#44; Per&#250; lamentaba la p&#233;rdida de 125 m&#233;dicos en todo el territorio nacional<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">24</span></a>&#46; A su vez&#44; la preocupaci&#243;n del personal de salud no solo afecta a su esfera &#237;ntima&#44; sino que enmarca el riesgo de contagio al que expone a sus familiares&#44; entre los que se cuentan padres &#40;mayores de 65 a&#241;os&#41;&#44; hijos &#40;ni&#241;os peque&#241;os&#41; y familiares cercanos &#40;pacientes con comorbilidades&#41;&#44; lo que en el peor de los casos podr&#237;a significar la muerte de alguno de ellos&#46; Por lo tanto&#44; la carga emocional y el estr&#233;s al que est&#225;n sometidos por lo complejo de su labor profesional se suman al riesgo que representa para sus familiares m&#225;s cercanos&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">De manera que la creaci&#243;n y la validaci&#243;n de una escala que permita medir la preocupaci&#243;n que el personal de salud experimenta a raz&#243;n de la labor que realizan adquiere una importancia capital&#44; sobre todo en tiempos de pandemia&#46; Un objetivo similar tuvieron Mejia et al&#46;&#44; quienes dise&#241;aron algunas escalas que fueron validadas durante los momentos &#225;lgidos de la pandemia peruana y contaron con una muestra muy variada que recogi&#243; poblaciones de diferentes partes de Per&#250;&#44; incluso tomando ciudades tan aisladas como Iquitos&#46; Es as&#237; como la escala F-COVID-19 se propuso como instrumento para determinar la fatalidad percibida entre la poblaci&#243;n general de Per&#250;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">14</span></a>&#46; Su aplicaci&#243;n permiti&#243; observar en una muestra de 2&#46;466 personas en 20 ciudades de Per&#250; que las mujeres y los que conviv&#237;an con alguna comorbilidad eran m&#225;s propensos a ideas fatalistas como morirse&#44; contagiarse o deprimirse<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">25</span></a>&#46; Por otro lado&#44; ese mismo equipo de trabajo desarroll&#243; la escala MED-COVID-19&#44; que mide la magnitud de la percepci&#243;n de miedo generada por la informaci&#243;n divulgada por los medios de comunicaci&#243;n y el c&#237;rculo m&#225;s cercano de los participantes<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">15</span></a>&#46; Con esta escala se pudo conocer en una muestra de 4&#46;009 personas que la televisi&#243;n y las redes sociales fueron las que m&#225;s generaron noticias y emitieron informaci&#243;n que ocasionaba miedo entre sus receptores<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">26</span></a>&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">La actual escala EPPC-Cov19 muestra una estructura interna y una validez formal que se sostienen con valores de V de Aiken<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;70&#46; De modo similar&#44; otros estudios que han medido variables relacionadas con los aspectos psicopatol&#243;gicos de la pandemia han obtenido valores de V de Aiken parecidos a los de esta validaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">14&#44;15&#44;18</span></a>&#46; Con respecto al an&#225;lisis factorial exploratorio&#44; los m&#233;todos utilizados permitieron agrupar la totalidad de los &#237;tems en un solo factor&#46; Otros estudios de validaci&#243;n&#44; como el realizado por Ruiz Mamani et al&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">16</span></a> que ten&#237;a como objetivo medir la preocupaci&#243;n durante los tiempos de COVID-19&#44; alcanzaron la consistencia adecuada al agrupar sus 6&#160;&#237;tems en 1&#160;solo factor&#46; Sin embargo&#44; validaciones realizadas en otros contextos&#44; como la desarrollada por Chandu et al&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">27</span></a> en una muestra de la India&#44; alcanzaron agrupaci&#243;n de sus &#237;tems con 2&#160;factores&#46; Ser&#237;a oportuno agregar que esta pose&#237;a muchos m&#225;s elementos que los contenidos en el presente instrumento&#46; Adem&#225;s&#44; la confiabilidad medida por el coeficiente alfa de Cronbach fue adecuado &#40;&#62;&#160;0&#44;80&#41;&#44; tal como propusieron Gliem et al&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">28</span></a>&#46; De manera que la escala EPCov-19 obtuvo coeficientes similares al de esta validaci&#243;n al evaluar su confiabilidad<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">16</span></a>&#46; La escala MED-COVID-19&#44; sin embargo&#44; alcanzo valores de &#945;<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;90<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">15</span></a>&#44; pero la escala F-COVID-19 obtuvo valores de 0&#44;70<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">14</span></a>&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">El estudio presenta algunas limitaciones&#46; La primera se relaciona con el m&#233;todo de muestreo empleado&#44; que no permite extrapolar sus resultados m&#225;s all&#225; del contexto en el que fue realizado&#59; adem&#225;s&#44; ser&#237;a importante realizar un an&#225;lisis de invarianza factorial&#46; Adem&#225;s&#44; no se realizaron grupos focales en las fases iniciales de construcci&#243;n de la escala ni evaluaciones en la poblaci&#243;n objetivo&#44; como tampoco an&#225;lisis de confiabilidad del tipo prueba-reprueba&#44; lo cual debe ser considerado al momento de reproducirla en otros contextos&#46; Sin embargo&#44; la evidencia de validez basada en el contenido&#44; la estructura interna y el nivel de confiabilidad alcanzados permiten tener confianza en que su aplicaci&#243;n y su validaci&#243;n en otras realidades ser&#225; igual de provechosa que en esta experiencia&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">La presente escala pretende levantarse como instrumento para poder generar pol&#237;ticas p&#250;blicas que permitan mejorar las condiciones y el estado de salud mental del personal de salud que se encuentra a cargo del tratamiento de la pandemia en los diferentes pa&#237;ses de la regi&#243;n latinoamericana&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Por lo tanto&#44; se concluye que la escala EPPC-Cov19 tiene la validez de forma y fondo y la confiabilidad necesaria para evaluar la preocupaci&#243;n por el contagio que sufre el personal de salud peruano durante la pandemia de COVID-19&#46; Adem&#225;s&#44; se propone utilizar este instrumento para medir la implicancia real de este problema en esa poblaci&#243;n en espec&#237;fico&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Conflicto de intereses</span><p id="par0115" class="elsevierStylePara elsevierViewall">Ninguno&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La pandemia mundial producida por el SARS-CoV-2<span class="elsevierStyleHsp" style=""></span>ha generado preocupaci&#243;n por el contagio&#44; sobre todo en el personal de salud que est&#225; en primera l&#237;nea&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Dise&#241;ar y analizar las evidencias de validez de contenido&#44; estructura interna y confiabilidad de una medida de preocupaci&#243;n por el contagio de COVID-19 en personal de salud peruano&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Material y m&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudio cuantitativo y dise&#241;o instrumental&#46; La escala se aplic&#243; a 321 profesionales de ciencias de la salud &#40;78 varones y 243 mujeres&#41; con edades comprendidas entre los 22 y los 64 &#40;38&#44;12<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#44;61&#41; a&#241;os&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Los valores del coeficiente V de Aiken fueron estad&#237;sticamente significativos&#46; Se realiz&#243; un an&#225;lisis factorial exploratorio&#44; que indic&#243; la existencia de un solo factor&#46; El an&#225;lisis factorial confirmatorio &#40;AFC&#41; confirm&#243; un modelo satisfactorio de 6&#160;&#237;tems en 1&#160;solo factor&#46; La soluci&#243;n del AFC obtuvo &#237;ndices de ajuste adecuados &#40;RMSEA<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;079&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#59; TLI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;967&#59; CFI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;980&#59; GFI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;971 y AGFI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;931&#41;&#59; adem&#225;s&#59; mostr&#243; una buena consistencia interna seg&#250;n el coeficiente alfa de Cronbach &#40;&#945;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;865&#59; IC95&#37;&#44; 0&#44;83-0&#44;89&#41;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La escala de preocupaci&#243;n por el contagio de la COVID-19 es una medida breve v&#225;lida y confiable que se puede utilizar para fines de investigaci&#243;n y funci&#243;n profesional&#46;</p></span>"
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The global SARS-CoV-2 pandemic has generated concern about contagion&#44; especially among healthcare workers who are on the front line&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objective</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To design and analyse the evidence of content validity&#44; internal structure and reliability of a measure of concern about the spread of COVID-19 among Peruvian healthcare workers&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Material and methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Quantitative study and instrumental design&#46; The scale was administered to 321 health science professionals &#40;78 males and 243 females&#41;&#44; whose ages ranged from 22 to 64 years &#40;38&#46;12<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;61&#41;&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Aiken&#39;s V-coefficient values were statistically significant&#46; An exploratory factor analysis was performed which indicated the existence of a single factor&#44; and confirmatory factor analysis &#40;CFA&#41; confirmed a satisfactory six-factor model&#46; The CFA solution obtained adequate fit indices &#40;RMSEA<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;079&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#59; TLI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;967&#59; IFC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;980&#59; GFI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;971&#44; and AGFI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;931&#41;&#44; and showed good internal consistency based on Cronbach&#39;s alpha coefficient &#40;&#945;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;865&#59; CI 95&#37;&#44; 0&#46;83-0&#46;89&#41;&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">The scale of concern for COVID-19 infection is a valid and reliable brief measure that can be used for research and professional purposes&#46;</p></span>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">M<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">DE<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">V<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">IC95&#37;<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">d</span></a>&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">M&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">DE&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">V&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">IC95&#37;&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">M&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">DE&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">V&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">IC95&#37;&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">&#205;tem 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">2&#44;88&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;35&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;96&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;80-0&#44;99&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">2&#44;88&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;35&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;96&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;80-0&#44;99&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">2&#44;88&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;35&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;96&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;80-0&#44;99&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">&#205;tem 2&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">2&#44;75&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;46&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;92&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;74-0&#44;98&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">2&#44;63&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;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">0&#44;88&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;69-0&#44;96&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">2&#44;38&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;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">0&#44;79&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;60-0&#44;91&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">&#205;tem 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">2&#44;88&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;35&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;96&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;80-0&#44;99&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">2&#44;75&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;46&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;92&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;74-0&#44;98&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">2&#44;63&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;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">0&#44;88&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;69-0&#44;96&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">&#205;tem 4&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;00&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;00&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;00&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;86-1&#44;00&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;00&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;00&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;00&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;86-1&#44;00&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">2&#44;88&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;35&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;96&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;80-0&#44;99&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">&#205;tem 5&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;00&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;00&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;00&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;86-1&#44;00&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;00&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;00&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">1&#44;165&nbsp;\t\t\t\t\t\t\n
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                  <table border="0" frame="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#205;tems&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">F1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">h2<a class="elsevierStyleCrossRef" href="#tblfn0045">&#42;</a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">1&#46;</span> Me preocupa la posibilidad de contagiarme de la COVID-19 durante mis horas de trabajo&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;753&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">0&#44;567&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
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                  \t\t\t\t"><span class="elsevierStyleItalic">2&#46;</span> Pensar en la posibilidad de contagiarme con la COVID-19 mientras realizo mi trabajo me angustia &#40;me pone nervioso&#47;a&#44; ansioso&#47;a&#41;&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\ttop\n
                  \t\t\t\t">0&#44;826&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;683&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
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">3&#46;</span> Pensar en la posibilidad de contagiarme con la COVID-19 en mi ambiente de trabajo no me deja dormir bien&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;787&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">0&#44;619&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
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                  \t\t\t\t"><span class="elsevierStyleItalic">4&#46;</span> Pensar en la posibilidad de contagiarme con la COVID-19 afecta a mi capacidad para realizar mis actividades laborales y personales&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">0&#44;748&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">0&#44;56&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
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                  \t\t\t\t"><span class="elsevierStyleItalic">5&#46;</span> Al salir del trabajo&#44; me preocupa contagiar la COVID-19 a mis familiares o personas con que vivo&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">0&#44;548&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"><span class="elsevierStyleItalic">6&#46;</span> La COVID-19 me causa incertidumbre porque es una enfermedad impredecible&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;799&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;638&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
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                  \t\t\t\t"><span class="elsevierStyleItalic">7&#46;</span> En mi centro laboral hay muchos riesgos &#40;altas tasas de contagios&#44; escasez de EPP&#44; problemas con los seguros de salud&#44; etc&#46;&#41; que me generan preocupaci&#243;n de contagiarme la COVID-19&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;359&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
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                  \t\t\t\t"><span class="elsevierStyleItalic">8&#46;</span> A pesar de poner en pr&#225;ctica las medidas de bioseguridad para no contagiarme la COVID-19&#44; no puedo evitar seguir preocup&#225;ndome&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;864&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;746&nbsp;\t\t\t\t\t\t\n
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Información del artículo
ISSN: 00347450
Idioma original: Español
DOI:10.1016/j.rcp.2021.03.006
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