Adaptación en español de la escala de actitudes ante cuidados paliativos: confiabilidad y análisis factorial

This instrumental study presents the reliability and factor analysis as part of the Spanish adaptation of the Scale of Attitudes Palliative Care (PSST). I was done with the aim of knowing if the scale has psychometric properties, to be used to assess attitudes with health staff towards palliative care. He had a sample of 132 health professionals (80.3% women), aged between 20 and 40 years (M = 30, SD = 9.11). Exploratory and confirmatory analysis showed a satisfactory rate of reliability (Cronbach’s alpha: 0.807) to explain the 65,063% of the variance and factorial solution containing the correlations between the original variables and each of the factors. Among the most important factors we consider: Factor 1 refers to the process and guidelines for care units Palliative Care Factor 2 that relate personal experiences with death; and Factor 5 which relate to social support have Palliative Care. Concluding that the scale fulfills the psychometric properties for use in both clinical and research field.Este estudio instrumental presenta los criterios de confiabilidad y análisis factorial como parte de la adaptación en español de la Escala de Actitudes ante los Cuidados Paliativos (EACP). Se realizó con el objetivo de conocer si la escala cuenta con las propiedades psicométricas para poder ser utilizado para evaluar las actitudes que tienen el personal de salud hacia los cuidados paliativos. Se contó́ con una muestra de 132 profesionales de la salud (80,3% mujeres), con edades comprendidas entre los 20 y 40 años (M = 30; DT = 9,11). Los análisis exploratorios y confirmatorios mostraron un índice de fiabilidad satisfactorio (Alfa de Cronbach: 0,807) que expliquen el 65,063% de la varianza y la solución factorial que contiene las correlaciones entre las variables originales y cada uno de los factores. Dentro de los factores más relevantes consideramos: El Factor 1 que hacen referencia al proceso o directrices de atención en las unidades de Cuidados Paliativos, el Factor 2 que se relacionan con las experiencias personales ante la muerte; y el Factor 5 que se refieren al apoyo social que tienen los Cuidados Paliativos. Concluyendo que la escala cumple con las propiedades psicométricas para ser utilizada tanto en el campo clínico como en la investigación

Spanish adaptation of the scale of attitudes towards palliative care: reliability and factor analysis

This instrumental study presents the reliability and factor analysis as part of the Spanish adaptation of the Scale of Attitudes Palliative Care (PSST). I was done with the aim of knowing if the scale has psychometric properties, to be used to assess attitudes with health staff towards palliative care. He had a sample of 132 health professionals (80.3% women), aged between 20 and 40 years (M = 30, SD = 9.11). Exploratory and confirmatory analysis showed a satisfactory rate of reliability (Cronbach’s alpha: 0.807) to explain the 65,063% of the variance and factorial solution containing the correlations between the original variables and each of the factors. Among the most important factors we consider: Factor 1 refers to the process and guidelines for care units Palliative Care Factor 2 that relate personal experiences with death; and Factor 5 which relate to social support have Palliative Care. Concluding that the scale fulfills the psychometric properties for use in both clinical and research field

Educational program on death and palliative care in health professionals

Introduction: The existing relationship between health personnel and death, have an inevitable emotional involvement, since they live and coexist daily with death. OBJECTIVE: To know the effect of an Educational Program on Death and Palliative Care (PEMyCP), based on the notion of illness and death in Mexico. Method: Comparative quasi-experimental study, non-probabilistic sampling for convenience, pretest-posttest design of a single group, with health professionals in Mexico. The instruments used were: Scale of attitudes before the palliative care, Questionnaire of professional competences and Scale of anxiety before the death of Templer. Through frequency analysis, tests t for related samples and analysis of variance ANOVA. Results: The PEMyCP had a positive impact on the attitudes towards palliative care (t = -2.0050, p = 0.44), on professional abilities (t = 6.969, p= 0.00), and anxiety about death (t=2.991, p=0.15). ANOVA was performed, found significant changes in knowledge (F=8.5988, p= 0.0000) and abilities (skills) (F= 6.1197, p=0.0000); however, no changes in attitudes were identified (F= 0.76131, p= 0.63738). In the anxiety before death, are observed statistically significant differences (F=4.0048, p=0.00919). Conclusions: The PEMyCP had a favorable impact on knowledge, abilities and anxiety in the face of death, but not in the attitudes towards death and palliative care, since it takes more time to modify them because not only cognitive aspects are acquired, but also affective and behavioral through the own experience

Proceso de atención psicológica en el programa de atención y cuidados en oncología del instituto nacional de cancerología

Coping in advanced cancer involves physical problems and emotional discomfort for the patient and his family, which is why psychological care care is a priority in palliative care. Cognitive behavioral therapy is one of the theoretical frameworks applied in the care of palliative patients and aims modifying thoughts and behaviors regarding the disease that are dysfunctional and negative impact the welfare of the patient and family. The aim of the study was to describe the psychological process in Program of Care in Oncology in The National Cancer Institute, general characteristic, cancer and psychological diagnoses and psychological techniques most used. We performed a retrospective study trasnversal and descriptive in population attended from February 2011 to March 2013. Total sample was 5588 patients. Data were processed with frequency analysis. The types of cancer most frequently attended were: gastrointestinal, breast and cervical, finding most of them with impact and adaptive processes are outside the oncology treatment. The most widely used psychological techniques were:a) Psychoeducation, b) Emotional expression and regulation c) emotional validation, d) Emotional containment, and e) Problem-solving.Enfrentarse a un cáncer avanzado implica un gran malestar físico y emocional para el paciente y su familia, es por ello que la atención psicológica es una prioridad en los cuidados paliativos. La terapia cognitivo-conductual es uno de los marcos teóricos más aplicados en la atención del paciente paliativo y tiene por objetivo la modificación de pensamientos y conductas respecto a la enfermedad que resultan disfuncionales y que impactan negativamente en el bienestar del paciente y sus familiares. El objetivo del estudio fue describir el proceso de atención psicológica en el Programa de Atención y Cuidados en Oncología del Instituto Nacional de Cancerología, así como las caracteristicas generales, diagnósticos oncológicos y psicológicos; y las técnicas de intervención psicológica más empleadas. Se realizo un estudio retrospectivo, trasnversal y descriptivo de la población atendida de febrero del 2011 a marzo del 2013. Con una muestra total de 5.588 pacientes. Se procesaron los datos a traves del análisis de frecuencias, obteniendo que dentro de los diagnósticos oncológicos más frecuentes el cáncer de estómago, mama y cervicouterino; encontrando en la mayoría de ellos, impacto emocional y procesos adaptativos al encontrarse fuera de tratamiento oncológico y cuyas técnicas psicológicas más aplicadas fueron: a) Psicoeducación, b) Expresión y regulación emocional c) Validación emocional, d) Contención emocional, y e) Solución de problemas

The psychological process in program of care in oncology in the National Cancer Institute.

Coping in advanced cancer involves physical problems and emotional discomfort for the patient and his family, which is why psychological care care is a priority in palliative care. Cognitive behavioral therapy is one of the theoretical frameworks applied in the care of palliative patients and aims modifying thoughts and behaviors regarding the disease that are dysfunctional and negative impact the welfare of the patient and family. The aim of the study was to describe the psychological process in Program of Care in Oncology in The National Cancer Institute, general characteristic, cancer and psychological diagnoses and psychological techniques most used. We performed a retrospective study trasnversal and descriptive in population attended from February 2011 to March 2013. Total sample was 5588 patients. Data were processed with frequency analysis. The types of cancer most frequently attended were: gastrointestinal, breast and cervical, finding most of them with impact and adaptive processes are outside the oncology treatment. The most widely used psychological techniques were:a) Psychoeducation, b) Emotional expression and regulation c) emotional validation, d) Emotional containment, and e) Problem-solving

Concepto de espiritualidad del equipo multidisciplinario de una unidad de cui¬dados paliativos: un estudio descriptivo

Spirituality is a fundamental need in palliative care; however, the literature reports that there are inconsistencies in the definition of the terms “spirituality” and “religiosity,” which creates confusion in how to approach these issues with the patients. The present study was exploratory, with the aim to better understand the concept of spirituality and religiosity that a multidisciplinary team has in an oncology palliative care unit. The study was not experimental, cross-sectional and descriptive, with 34 health professionals. To obtain each concept, the natural semantic networks technique was used; using two stimulus words: spirituality and religiosity. Among the results, similarities between the two concepts were found, being both defined as faith, god, belief, love, religion, hope. However, there are differences that distinguish the concept of spirituality; defined as peace, soul, tranquility, harmony, meditation, kindness, spirit, and transcendence; from the concept of religiosity; defined as church, rituals, bigotry, spirituality, commitment, prayer, rules, and priest. Concluding that the concepts are confusing to the palliative care team, however they have personal resources to identify the spiritual needs although they lack of information and formal training to address this.La espiritualidad, es una necesidad fundamental en el cuidado paliativo, sin embargo, la literatura reporta que existen inconsistencias en la definición de los términos “espiritualidad” y “religiosidad”, lo que genera confusión en su abordaje con los pacientes. El presente estudio fue exploratorio, con el objetivo de conocer la concepción de espiritualidad y religiosidad que tiene un equipo multidisciplinario en una unidad de cuidados paliativos oncológicos. El estudio fue no experimental, transversal y descriptivo; con 34 profesionales de la salud. Para la obtención del concepto se empleó la técnica de redes semánticas naturales, utilizando dos palabras estímulo: Espiritualidad y Religiosidad. Dentro de los resultados se encontraron semejanzas entre ambas palabras, al ser definidos como: fe, dios, creencia, amor, religión, esperanza, creencias. Sin embargo, se presentan diferencias en el concepto de espiritualidad; definida como paz, alma, tranquilidad, armonía, meditación, bondad, espíritu; y trascendencia; mientras que el concepto de religiosidad; fue definida como iglesia, ritos, fanatismo, espiritualidad, compromiso, oración, reglas, y sacerdote. Concluyendo que los conceptos resultan confusos para el equipo de cuidados paliativos, sin embargo, cuentan con recursos personales para identificar las necesidades espirituales aunque carecen de información y entrenamiento formal para su abordaje

The concept of spirituality in a multidisciplinary team from a palliative care unit: A descriptive study

Spirituality is a fundamental need in palliative care; however, the literature reports that there are inconsistencies in the definition of the terms “spirituality” and “religiosity,” which creates confusion in how to approach these issues with the patients. The present study was exploratory, with the aim to better understand the concept of spirituality and religiosity that a multidisciplinary team has in an oncology palliative care unit. The study was not experimental, cross-sectional and descriptive, with 34 health professionals. To obtain each concept, the natural semantic networks technique was used; using two stimulus words: spirituality and religiosity. Among the results, similarities between the two concepts were found, being both defined as faith, god, belief, love, religion, hope. However, there are differences that distinguish the concept of spirituality; defined as peace, soul, tranquility, harmony, meditation, kindness, spirit, and transcendence; from the concept of religiosity; defined as church, rituals, bigotry, spirituality, commitment, prayer, rules, and priest. Concluding that the concepts are confusing to the palliative care team, however they have personal resources to identify the spiritual needs although they lack of information and formal training to address this

Efectos de la solución de problemas sobre los comportamientos de autocuidado de cuidadores de pacientes oncológicos en fase paliativa: un estudio piloto

Caring for a relative with terminal cancer brings a series of problems in the family, work, financial and social arenas. These problems, in turn, cause a negative impact on the Quality of Life (QOL) of the patients’ primary caregivers, including their physical and psychological health. The purpose of the present study was to examine the effects of an intervention based on Problem Solving Therapy on QOL, anxious and depressive symptoms and on the acquisition of self-care skills by terminal cancer patients’ primary caregivers. A repeated measures N=1 design was used on pre and post intervention measurements on Beck’s anxiety and depression inventories, the WHOQOL-Bref and a questionnaire on self-care expressly designed for the study. Results revealed clinically significant improvements on anxious and depressive symptoms and improvement on the participants’ QOL. Problem Solving Therapy resulted a viable and effective approach to cope with the problems posed by caring for a terminal patient and improving self-care skills. A possible drawback of the procedures includes a lengthy intervention howhich was not always commensurate with the survival time of the terminal patients.Cuidar de un familiar con cáncer avanzado trae consigo una serie de problemas familiares, laborales, económicos, y sociales que impactan negativamente sobre la calidad de vida y la salud física y psicológica de los cuidadores primarios. El objetivo de la presente investigación fue evaluar la eficacia de una intervención basada en la terapia de solución de problemas sobre la adquisición de habilidades de autocuidado, la calidad de vida, y la sintomatología ansiosa y depresiva en cuidadores primarios de pacientes que reciben cuidados paliativos. Se utilizó un diseño de N=1 de medidas repetidas, con evaluación pre y post- test con los inventarios de ansiedad y depresión de Beck, el inventario de calidad de vida WHOQol Bref y un cuestionario de conductas de autocuidado diseñado ex profeso para esta investigación. Se identificaron mejorías clínicamente significativas en las medidas de sintomatología ansiosa y depresiva, un incremento en la calidad de vida y la identificación de la Terapia de Solución de Problemas como una herramienta útil para afrontar las problemáticas derivadas de las actividades de cuidado. La principal limitante para el desarrollo de la intervención fue que el tiempo propuesto no correspondió con el promedio de sobrevida de los pacientes atendidos en el servicio

Clinical practice guideline for psychooncologic diagnosis and treatment of primary caregivers of cancer patients

Introducción: Los cuidadores primarios representan un papel crucial en la atención de los pacientes con cáncer, lo que comúnmente representan tareas complejas de cuidado. Los cuidadores de los pacientes pueden experimentar diversas afectaciones físicas y psicológicas, así como un funcionamiento social deficiente.Objetivo: Proporcionar a los servicios de psicooncología un algoritmo con los elementos suficientes que faciliten el diagnóstico y tratamiento psicosocial de cuidadores primarios de pacientes con cáncer. Método: Se realizó una búsqueda de la literatura en PsycInfo, LatinIndex y Medline en el período de 2005-2014.Resultados: El presente algoritmo se divide en dos momentos clave: 1). Evaluación y 2). Tratamiento del cuidador primario. Los instrumentos más empleados para ansiedad y depresión son: CES-D, BDI, IDARE, HADS y POMS. Para carga el ECCZ y CRA; las intervenciones psico-educativa, capacitación y orientación terapéutica presentan efectos benéficos para esta población.Conclusiones: El algoritmo ofrece un proceso de toma de decisiones para el diagnóstico y tratamiento psicooncológico del cuidador primario informal.Introduction: The primary caregivers play a crucial role in the care of cancer patients, which commonly represent complex care tasks. Caregivers of patients may experience various physical and psychological effects, and poor social functioning.Objective: To provide at psychooncology services of an algorithm with sufficient elements for diagnosis and psychosocial treatment of primary caregivers of patients with cancer elements. Method: A literature search in PsycInfo, Medline LatinIndex in the period of 2005 to 2014.Results: This algorithm is divided into two key points: 1) Evaluation and 2) Treatment of primary caregiver. More used instruments are CES-D, BDI, IDARE, HADS and POMS. For Burden ECCZ and CRA; the psycho-educational interventions, training and therapeutic orientation have beneficial effects for this population.Conclusions: The algorithm provides a process of decision making for the diagnosis and psychooncologic treatment of the primary caregiver

Effects of problem solving therapy on self-care behaviors by primary caregivers of terminal cancer patients: A pilot study

Caring for a relative with terminal cancer brings a series of problems in the family, work, financial and social arenas. These problems, in turn, cause a negative impact on the Quality of Life (QOL) of the patients’ primary caregivers, including their physical and psychological health. The purpose of the present study was to examine the effects of an intervention based on Problem Solving Therapy on QOL, anxious and depressive symptoms and on the acquisition of self-care skills by terminal cancer patients’ primary caregivers. A repeated measures N=1 design was used on pre and post intervention measurements on Beck’s anxiety and depression inventories, the WHOQOL-Bref and a questionnaire on self-care expressly designed for the study. Results revealed clinically significant improvements on anxious and depressive symptoms and improvement on the participants’ QOL. Problem Solving Therapy resulted a viable and effective approach to cope with the problems posed by caring for a terminal patient and improving self-care skills. A possible drawback of the procedures includes a lengthy intervention howhich was not always commensurate with the survival time of the terminal patients