Revisiting the Mackey Childbirth Satisfaction Rating Scale: Spanish adaptation, factor analysis, and sources of construct validity

Background: Women's dissatisfaction with perinatal health care services is associated with poor postpartum outcomes for the mother and the baby. The Mackey Childbirth Satisfaction Rating Scale is a frequently used measure of women's childbirth satisfaction. However, its factor structure has been inconsistent across investigations. The goal of this study was to evaluate the psychometric properties of the scale (i.e., factor structure and sources of validity evidence). Methods: This study is a descriptive prospective investigation. Participants included 106 pregnant women (mean age = 31.86, SD = 4.12) recruited from a public university hospital situated in South Madrid. Sources of construct validity of the Mackey were explored with the Women's View of Birth Labor Satisfaction Questionnaire. Sources of criterion validity were investigated with measures of pain (labor, delivery, and just after birth) and post-traumatic stress symptoms. Results: Minor adaptations in item distribution resulted in an adequate fit of the original six-factor solution of the Mackey scale (i.e., oneself, the partner, the baby, the nurse, the physician, and overall satisfaction). Sources of validity evidence supported the construct and criterion validity of the scale. Conclusions: Obtaining a psychometrically and conceptually sound factor solution is fundamental when validating a scale. With the present study, researchers and clinicians (e.g., midwives) will be able to measure women's childbirth satisfaction in a more robust manner. Both antecedents and consequences of satisfaction were found to correlate with several satisfaction subscales, which might help guide prevention programs in mother care in a more efficient way.The study was funded by the Health Research Fund (Fondo de Investigaciones Sanitarias, FIS), grant number PI07/0571 from the Instituto de Salud Carlos III (Spain). Dr. Suso-Ribera also obtained a grant from Jaume I University to conduct this study (E-2019-06)

Associations of Cognitive Fusion and Pain Catastrophizing with Fibromyalgia Impact through Fatigue, Pain Severity, and Depression: An Exploratory Study Using Structural Equation Modeling

Differences in fibromyalgia impact on functioning exist and appear to be influenced by numerous factors, including symptomatology severity, as well as the cognitive profile of the individual. The contribution of these elements, however, tends to be explored in a fragmented manner. To address this issue, we tested a comprehensive structural equation model in which associations of cognitive fusion and pain catastrophizing with function limitations are investigated through fibromyalgia symptomatology (i.e., fatigue, pain severity, and depression) in 231 women with fibromyalgia. In the model, cognitive fusion and two catastrophizing components (magnification and helplessness) were associated with poorer functioning indirectly through fibromyalgia symptomatology. Only the rumination component of catastrophizing had a direct association with functional limitations. All fibromyalgia symptoms were linked to increased functional limitations. A parsimonious model with significant associations only obtained an excellent fit (S-B χ2 = 774.191, df = 543, p < 0.001; CFI = 0.943; RMSEA = 0.043; CAIC = −2724.04) and accounted for 50% of the variance of functional limitations. These results suggest that the relationship between psychological cognitive processes, fibromyalgia symptomatology, and functional limitations is complex and support the need for comprehensive models such as the present. The findings are discussed in the context of personalized psychological treatments (i.e., the need to address certain cognitive processes according to the problematic symptomatology or outcome)

The Contribution of the Psychologist in the Assessment and Treatment of Fibromyalgia

Altres ajuts: acords transformatius de la UABPurpose of review This review focuses on the role of psychologists in the assessment and treatment of fibromyalgia syndrome (FMS), a highly prevalent condition characterized by chronic widespread pain, fatigue, cognitive problems, distress, and disability. Recent findings A large body of work supports the effectiveness and cost-utility of psychological therapies for the improvement of a wide range of symptoms associated with FMS. However, patients with FMS are best assessed and treated by a multidisciplinary team, in which psychologists have an important role. Multidisciplinary treatment, in which each healthcare professional offers his or her own expertise to the patient, has been shown to produce more ubiquitous treatment effects for this complex syndrome than single discipline treatments. Considering the empirical evidence and documented experience of patients, people with FMS can benefit from integrated care, combining education, exercise, and psychotherapeutic approaches, including cognitive-behavioral therapy. Summary There has been a call for more health economics research to demonstrate the cost-effectiveness of psychological therapies. In this paper, we highlight the added value of psychologists as members of multidisciplinary treatment teams, who can assess and treat the maladaptive cognitive, emotional, and behavioral symptoms that are commonly seen in individuals with FMS

Perception of quality of life by children and adolescents with cleft lip/palate after orthodontic and surgical treatment: gender and age analysis

Background: The quality of life (QoL) of children and adolescents with cleft lip/palate (CL/P) has been shown to be a predictor of good psychosocial functioning in this population group. This study aimed to measure QoL, from the patient´s perception of change produced by the different surgical and orthodontic treatments carried out since early childhood, and if gender and age are modulating the outcome variables results. Materials and methods: A cross-sectional research study was carried out. The study included 60 patients with cleft lip, cleft palate, or cleft lip/palate, aged between 8 and 18, who were in orthodontic treatment and had undergone at least one surgery. They were asked to complete the Quality-of-Life Adolescent Cleft Questionnaire (QoLAdoCleft), which allows the assessment of the QoL through self-perception of improvement after surgical and orthodontic interventions. In particular, this questionnaire (administered only once), allows the evaluation of self-perception of QoL at the present time and before orthodontic and surgical treatment. This double assessment was carried out for the domains of physical, psychological, and social health. The results were analysed by looking at the interaction of gender and age. Results: Statistically significant differences were found in the perception of the current QoL in comparison to the retrospective perception in all the dimensions considered. The perception of QoL improved in all cases. The results also showed a moderation of gender in the relation between perception of previous behaviour and social function and actual behaviour and social function. Conclusion: The results indicated that patients perceived their quality of life had improved as a result of the treatments received, with the highest effect sizes found in the physical health domain. Specifically, the improvement in QoL in behaviour and social function tended to be influenced to a greater extent by perception of previous QoL. In this sense, personalized preventative measures from holistic and biopsychosocial approaches are necessary

Las propiedades psicométricas del Cuestionario de Expectativas sobre el Parto en una muestra de mujeres españolas gestantes

Childbirth expectations during pregnancy are important factors related to birth satisfaction. The aim of this study is to validate the Childbirth Expectation Questionnaire (CEQ) in a sample of Spanish pregnant women; 231 women responded to the CEQ during their first trimester of pregnancy and 106 of them completed a re-test at the third trimester. Exploratory analyses with 1-to-6 factor solutions were carried out to investigate the internal structure of the CEQ. The three-factor solution (spousal support and control, medical support and environment, and labor pain and distress) showed the best properties in terms of model fit, number of items per factor, and item loadings. The internal consistency of scales was also good (.79 ≥ α ≤ .93). Test-retest analyses showed significant intercorrelations between expectations from the first to the third trimester of pregnancy. There is a need to assess childbirth expectations, and our results suggest that the CEQ is a valid and useful instrument to be used among Spanish pregnant women.Las expectativas sobre el parto (evaluadas durante el embarazo) constituyen factores relevantes relacionados con la satisfacción del parto. El objetivo de este estudio es validar el Cuestionario de Expectativas sobre el Parto (CEQ según las siglas del nombre inglés) en una muestra de gestantes españolas. Un total de 231 mujeres cumplimentaron el CEQ durante el primer trimestre del embarazo y 106 de ellas cumplimentaron de nuevo el instrumento en el tercer trimestre. Se realizaron análisis exploratorios con soluciones factoriales de 1 a 6 factores para analizar la estructura interna del CEQ. La solución de tres factores (apoyo de la pareja y control, apoyo médico y ambiente y dolor durante el parto y malestar) mostró las mejores propiedades en cuanto a ajuste del modelo, número de ítems por factor y peso de los ítems. La consistencia interna de las escalas también fue buena (.79 ≥ α ≤ .93). Los análisis test-retest mostraron intercorrelaciones significativas entre las expectativas del primer y tercer trimestre del embarazo. Atendiendo a la necesidad de evaluar las expectativas sobre el parto, nuestros resultados sugieren que el CEQ es un instrumento válido y útil para ser utilizado en las gestantes españolas

Efectos de una intervención psicológica y fisioterapeútica sobre la ocurrencia de lesiones

This study aims to analyse the effects of a psychological intervention focused on motivation and anxiety, in combination with a physiotherapy program, upon the occurrence of injuries. The participants were 22 male soccer players (age = 23.31, SD = 4.24). The instruments used were injury protocol, Competitive State Anxiety Inventory 2 (CSAI-2) and Behavioral Regulation in Sport Questionnaire (BRSQ). The program lasted twelve sessions a periodicity of weeks and with duration of approximately 30-40 minutes each. A pre/post-treatment design with three modalities was used: psychological treatment and physiotherapy (combined modality), physiotherapy and control. The groups are formed randomly with the Windows Excel program. The results on the indication of in-jury show that the physiotherapeutic treatment and the combined treatment reduce the appearance of injury compared to the control group during the intervention. In the long term (six months after the intervention), only the combined treatment significantly reduced the injury compared to the control group. The combined program produced a reduction of de-motivation levels and external regulation, along with an increase in intrinsic motivation (accomplishment) in comparison to the group who received physiotherapy on its own. Both interventions (combined and physiotherapy alone) were efficient in decreasing anxiety levels, although the combined group was more efficient, as well as being the only one that significantly improved self-confidence levels and intrinsic motivation. Nevertheless, because of the lack of previous literature in this area and because of the methodological difficulties further studies are required.Este estudio tiene como objetivo analizar los efectos de una intervención psicológica centrada en la motivación y la ansiedad, en combinación con un programa de fisioterapia, sobre la aparición de lesiones. Los participantes fueron 22 jugadores de fútbol masculinos (edad = 23.31, SD = 4.24). Los instrumentos utilizados fueron el protocolo de lesiones, el Inventario de ansiedad de estado competitivo 2 (CSAI-2) y el Cuestionario de regulación del comportamiento en el deporte (BRSQ). El programa duró doce sesiones con una periodicidad semanal y con una duracion de 30-40 minutos cada una. Se utilizó un diseño pre/post tratamiento con tres modalidades: tratamiento psicológico y fisioterapia (modalidad combinada), fisioterapia y control. Los grupos se formaron aleatoriamente con el programa Excel de Windows. Los resultados sobre la indicidencia de lesión muestran que el tratamiento fisioterapéutico y el tratamiento combinado reducen la aparición de lesión respecto al grupo control durante la intervención. A largo plazo (seis meses después de la intervención) únicamente el tratamiento combinado reduce significativamente la lesión respecto el grupo control. El programa combinado produjo una reducción de los niveles de desmotivación y regulación externa, junto con un aumento de la motivación intrínseca (logro) en comparación con el grupo que recibió fisioterapia por sí solo. Ambas intervenciones (combinadas y fisioterapia sola) fueron eficientes para disminuir los niveles de ansiedad, aunque el grupo combinado fue más eficiente, además de ser el único que mejoró significativamente los niveles de autoconfianza y la motivación intrínseca. Sin embargo, debido a la falta de literatura previa en esta área y debido a las dificultades metodológicas, se requieren más estudios.Actividad Física y Deport

Predicting walking as exercise in women with fibromyalgia from the perspective of the theory of planned behavior

Based on the theory of planned behavior, this study examined factors related to the intention to adhere to an unsupervised walking program and the intention-behavior gap in relation to walking adherence in women with fibromyalgia. We also accounted for specific variables: fear of movement, pain intensity, distress and disability. TPB constructs, walking behavior and the above-mentioned variables were assessed in 274 women aged 18 to 70 years old (mean 51.8, range 25.5–69.1 years) at baseline and seven weeks later (n = 219) during 2012. Intention to adhere to a walking program showed medium scores at baseline and was associated with attitude and perceived behavioral control (PBC). Self-reported walking adherence at Time 2 was only predicted by perceived behavioral control. The intention-behavior gap was present in 33% of participants. Logistic regression analysis showed PBC associated with being a successful intender. Women with fibromyalgia were motivated to walk; however, they did not act on their intentions, and PBC appeared as the main explanation. Women who perceived high control in comparison to those who perceived low control, increased their likelihood of adhering to a walking program about three-fold. Women with fibromyalgia should increase their perceived control through different strategies

Do women with fibromyalgia adhere to walking for exercise programs to improve their health? Systematic review and meta-analysis

Background: Walking is recommended for fibromyalgia, but the rate of adherence to this exercise is not known. Poor adherence to physical exercise can limit the effectiveness in health benefits. Objectives: To examine adherence to interventions that include walking for fibromyalgia and to explore its moderators among the characteristics of patients, of the walking prescription and of the interventions. Data sources: References from 2000 to 2016 have been collected through PubMed, PsycINFO, CINAHL, SPORTDiscus, Cochrane, and Teseo. Study selection: We included quasi-experimental and randomized controlled trials in adults with fibromyalgia that involved walking for exercise. Two authors screened records independently and disagreements were resolved by discussion. Data extraction: Independently extracted by two assessors. Methodological quality of the studies was assessed using an ad hoc scale. Data synthesis: Nineteen trials, 32 experimental groups, recruited a total of 983 participants (96.78% women) with mean ages between 45 and 60.60. Adherence to the intervention program was reported in 19 of 32 experimental groups and ranged, on average, from 73 to 87.20% depending on the type of assessment. Most relevant moderators of adherence were the recruitment of participants through physicians and the nurses as supervisors of exercise. Conclusion: Adherence rates (attendance at sessions) to programs with walking were high. However, a lack of information precludes knowledge of whether participants sustained walking between sessions or after the treatment. Further work is required to examine in greater depth such contextual variables of interventions as the professional-participant relationship or to explore other possible moderators such as patient expectations of the treatment

Nursing Motives for Helping Scale (N-MHS): Reliability and Validity

This paper presents the Nursing Motives for Helping Scale (N-MHS), an instrument designed for the evaluation of three of the four motives for helping derived from Batson’s helping pathway theory. Dimensionality was analyzed by means of principal component analysis (n = 113), followed by confirmatory factor analysis. A 3-factor structure (corresponding to Batson’s differentiation among altruistic motivation, reward-seeking motivation, and punishment-avoidance motivation, respectively), with 9 items distributed in three latent variables, revealed an acceptable fit to the data. Alpha values (.60 - .74) showed that internal consistency was acceptable for a newly developed subscale with a small number of items. Convergence validity was evaluated with correlations between N-MHS subscales scores and scores on the Professional Expectations Scale (Garrosa, Moreno-Jiménez, Rodríguez-Carvajal, & Morante, 2005). The three resulting subscales are a promising instrument for the evaluation of three nursing motives for helping that can contribute to reduce the potential risks and to improve the potential benefits both for the nurse and the patient.En este articulo se presenta la Escala de Motivaciones de Ayuda en Enfermería [The Nursing Motives for Helping Scale (N MHS)], un instrumento elaborado para evaluar tres de las cuatro motivaciones de ayuda derivadas del modelo de motivación prosocial de Batson. Se analizó la dimensionalidad mediante análisis de componentes principales (n = 113), seguido de análisis factorial confirmatorio. La estructura de 3 factores (correspondiendo a la diferenciación de Batson entre las motivaciones altruista, la de búsqueda de recompensa y la de evitación del castigo, respectivamente), con 9 ítems distribuidos en 3 variables latentes, mostró un ajuste aceptable a los datos. Los valores de alfa (.60 - .74) indicaron que la consistencia interna era aceptable para una subescala nueva con un número pequeño de ítems. La validez convergente se evaluó mediante las correlaciones entre las puntuaciones de las subescalas de la N-MHS y las puntuaciones en la Escala de Expectativas Profesionales (Garrosa, Moreno-Jiménez, Rodríguez-Carvajal y Morante, 2005). Las tres subescalas resultantes constituyen un instrumento prometedor para la evaluación de tres motivaciones de ayuda de enfermería que pueden contribuir a reducir los riesgos y a incrementar los beneficios potenciales tanto de los profesionales de enfermería como de los pacientes