The impact of information given to patients’ families: Breast cancer risk notification

A family history of breast cancer is a clear risk for developing the disease. Therefore, when a woman is diagnosed with breast cancer all her female first degree relatives become population at risk. This involve a number of important aspects to be taken into account by psychooncology professionals. (a) First, in addition to the stress associated with the diagnosis and treatment of breast cancer in a close relative, first degree relatives of breast cancer patients have the added stress of learning that they are at risk of this disease. (b) Second, these women become the main target of secondary breast cancer prevention strategies. However, various reports show that a considerable percentage of these women do not follow the recommended screening methods. For this reason, it is necessary to study the possible contribution of psychosocial factors, specially health beliefs, in the practice of preventive behavior aimed at preventing breast cancer in this population, and to design strategies to promote preventive practices. (c) Most of the research on health beliefs among women at risk for breat cancer has focused on risk perception.This research as found that some women with a family history of breast cancer have significantly overestimated their risk, while other shave underestimated their risk. The need to provide risk counselling schemes for these women is therefore proposed, in order to estimate and advise them of their real risk. (d) Finally, these women may request genetic testing to determine whether they carry genetic mutations (BRCA1, BRCA2, or others) that cause some types of breast cancer. However, it must be remembered that, although many first degree relatives will have heard of and seek «the cancer gene test», currently testing is appropiate and available only for rare individuals. All these issues are reviewed in the present paper

Características psicométricas del módulo general del cuestionario FertiQoL en una muestra española de mujeres infértiles

Background: Fertility diagnosis and treatment have an impact on the quality of life (QoL) of individuals. FertiQoL is an internationally developed questionnaire to measure fertility-specific QoL. Obtaining reliable information on the impact of fertility issues enables social and health care systems to develop value-centered integrated care. Objective: The aim of the present study is to examine the dimensionality, validity and reliability of Core FertiQol in a sample of Spanish women undergoing fertility treatment. Methods: A cross-sectional study was conducted, administering the Core FertiQoL questionnaire to 564 women with fertility problems. Descriptive analyses were performed on sociodemographic and clinical data of the sample. The psychometric properties of the FertiQoL were tested by performing confirmatory factor analyses, calculating the average values of the variance extracted, validity, reliability and correlation coefficients between scales. Results: Four factors (Emotional, Mind/Body, Relational and Social) were obtained. All statistics presented adequate values (RMSEA and SRMR lower than 0.09 and CFI and TLI higher than 0.9). Reliability was demonstrated with the CR index of each factor higher than 0.7 and the AVE higher than 0.5. Conclusions: Core FertiQol presents an acceptable adjustment for Spanish women with fertility problems. It offers a communication channel between professionals and patients, as well as accurate information in its subscales on areas that may reflect QoL impairment. Core FertiQol is an instrument that allows the identification of areas requiring support, providing valuable information for the design of efficient social-health value-centered programs for people with infertility.Antecedentes: El diagnóstico y el tratamiento de la fertilidad repercuten en la calidad de vida de las personas. FertiQoL es un cuestionario desarrollado internacionalmente para medir la calidad de vida específica de la fertilidad. La obtención de información fiable sobre el impacto de los problemas de fertilidad permite a los sistemas sociales y sanitarios desarrollar una atención integrada centrada en el valor. Objetivo: El objetivo del presente estudio es examinar la dimensionalidad, validez y fiabilidad del Core FertiQol en una muestra de mujeres españolas en tratamiento de fertilidad. Método: Se realizó un estudio transversal, administrando el cuestionario Core FertiQoL a 564 mujeres con problemas de fertilidad. Se realizaron análisis descriptivos de los datos sociodemográficos y clínicos de la muestra. Se comprobaron las propiedades psicométricas del FertiQoL realizando análisis factoriales confirmatorios, calculando los valores medios de la varianza extraída, la validez, la fiabilidad y los coeficientes de correlación entre escalas. Resultados: Se obtuvieron cuatro factores (Emocional, Mente/Cuerpo, Relacional y Social). Todos los estadísticos presentaron valores adecuados (RMSEA y SRMR inferiores a 0.09 y CFI y TLI superiores a 0.9). La fiabilidad quedó demostrada con el índice CR de cada factor superior a 0.7 y el AVE superior a 0.5. Conclusiones: El Core FertiQol presenta un ajuste aceptable para las mujeres españolas con problemas de fertilidad. Ofrece un canal de comunicación entre profesionales y pacientes, así como información precisa en sus subescalas sobre áreas que pueden reflejar deterioro de la CdV. El FertiQol básico es un instrumento que permite identificar áreas que requieren apoyo, proporcionando información valiosa para el diseño de programas sociosanitarios eficientes centrados en valores para personas con infertilidad

Involving Elderly and Disabled Tourists as Active Participants in Energy Savings

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Service quality scales and tourists with special needs: a systematic review

This paper reviews the most commonly used scales for measuring service quality in sustainable tourism destinations to analyse if the requirements of tourists with special needs are considered. Results highlight that most of the recent research on service quality in tourism published in scientific journals is focused on a relative reduced number of validated scales. Variables related to tourists with special needs are often omitted or represent a reduced weight in the complete scale. Thus, this paper highlights the importance of including variables that collect the perceptions of service quality in this target group to better understand the individual perception of service quality and to move forward to sustainable tourism, considering the social dimension

Características psicométricas del módulo general de cuestionario FertiQoL en una muestra española de mujeres infértiles

Background: Fertility diagnosis and treatment have an impact on the quality of life (QoL) of individuals. FertiQoL is an internationally de-veloped questionnaire to measure fertility-specific QoL. Obtaining reliable information on the impact of fertility issues enables social and health care systems to develop value-centered integrated care.Objective: The aim of the present study is to examine the dimensionality, validity and reliability of Core FertiQol in a sample of Spanish women undergoing fertility treat-ment. Methods: A cross-sectional study was conducted, administering the Core FertiQoL questionnaire to 564 women with fertility problems. De-scriptive analyses were performed on sociodemographic and clinical data of the sample. The psychometric properties of the FertiQoL were tested by performing confirmatory factor analyses, calculating the average values of the variance extracted, validity, reliability and correlation coefficients be-tween scales. Results: Four factors (Emotional, Mind/Body, Relational and Social) were obtained. All statistics presented adequate values (RMSEA and SRMR lower than 0.09 and CFI and TLI higher than 0.9). Reliability was demonstrated with the CRindex of each factor higher than 0.7 and the AVE higher than 0.5. Conclusions: Core FertiQol presents an acceptable ad-justment for Spanish women with fertility problems. It offers a communi-cation channel between professionals and patients, as well as accurate in-formation in its subscales on areas that may reflect QoL impairment. Core FertiQol is an instrument that allows the identification of areas requiring support, providing valuable information for the design of efficient social-health value-centered programs for people with infertility.Antecedentes: El diagnóstico y el tratamiento de la fertilidad re-percuten en la calidad de vida de las personas. FertiQoL es un cuestionario desarrollado internacionalmente para medir la calidad de vida específica de la fertilidad. La obtención de información fiable sobre el impacto de los problemas de fertilidad permite a los sistemas sociales y sanitarios desarrollar una atención integrada centrada en el valor. Objetivo: El objetivo del presente estudio es examinar la dimensionalidad, validez y fiabilidad del Core FertiQol en una muestra de mujeres españolas en tratamiento de fertilidad. Método: Se realizó un estudio transversal, administrando el cuestionario Core FertiQoL a 564 mujeres con problemas de fertilidad. Se realiza-ron análisis descriptivos de los datos sociodemográficos y clínicos de la muestra. Se comprobaron las propiedades psicométricas del FertiQoL realizando análisis factoriales confirmatorios, calculando los valores medios de la varianza extraída, la validez, la fiabilidad y los coeficientes de correlación entre escalas. Resultados: Se obtuvieron cuatro factores (Emocional, Mente/Cuerpo, Relacional y Social). Todos los estadísticos presentaron valores adecuados (RMSEA y SRMR inferiores a 0.09 y CFI y TLI superiores a 0.9). La fiabilidad quedó demostrada con el índice CR de cada factor superior a 0.7 y el AVE superior a 0.5. Conclusiones: El Core FertiQol presenta un ajuste aceptable para las mujeres españolas con problemas de fertilidad. Ofrece un canal de comunicación entre profesionales y pacientes, así como información precisa en sus subescalas sobre áreas que pueden reflejar deterioro de la CdV. El FertiQol básico es un instrumento que permite identificar áreas que requieren apoyo, proporcionando información valiosa para el diseño de programas sociosanitarios eficientes centrados en valores para personas con infertilidad

Edad, creencias de salud y asistencia a un programa de cribado mamográfico en la comunidad valenciana

Yolanda Andreu Vaillo, Mª José Galdón Garrido, Estrella Durá Ferrandis, Stephanie Carretero Gómez ([email protected])La edad influye significativamente en las creencias de salud relacionadas con la asistencia a programas de cribado mamográfico. El objetivo de este trabajo es analizar las creencias y actitudes hacia el cáncer de mama asociadas a la asistencia a un programa de cribado en diferentes grupos de edad.Métodos: Utilizando un diseño transversal se comparan las creencias de salud de un grupo de mujeres que acuden a un programa de cribado con las de las mujeres que no lo hacen, considerando tres intervalos de edad: menores de 50 años (N=279), 50-60 años (N=463), mayores de 60 (N=271). Resultados: Algunas variables diferencian significativamente entre las mujeres que acuden y no acuden al programa sólo en determinados subgrupos: gravedad percibida (50-60 años: F=5,14; p £ 0,01); beneficios percibidos (menos de 50 años: F=8,18; p £ 0,01; más de 60: F=4,54; p £ 0,05); actitud hacia la mamografía (menos de 50 años: F=56,67; p £ 0,001; más de 60: F=18,42; p £ 0,001); control de la salud por profesionales (menos de 50 años: F=11,30; p £ 0,01) y suerte o azar (menos de 50 años: F=3,78; p £ 0,05; 50-60 años: F=4,29; p £ ,001). Creencias más específicas, evaluadas por los items de estas variables, también alcanzan la significación estadística (p £ 0,05), aunque sólo para determinados intervalos de edad. Conclusiones: Las creencias y/o las actitudes de las mujeres relacionadas con la asistencia a los programas de prevención del cáncer de mama difieren en función de su edad.Background: Age has a significant bearing on health beliefs related to participating in breast cancer screening programs. This study is aimed at analyzing the breast cancer-related beliefs and attitudes influencing screening program participation among different age groups. Methods: In a transversal study, a comparison is drawn between the health-related beliefs of a group of women participating in a screening program and a group of non-participating women, taking into account three age ranges (under age 50 (N=279), 50-60 age range (N=463), and over age 60 (N=271). Results: Some variables significantly differ between the participating and non-participating women solely in certain subgroups: perceived severity (50-60 age group: F=5,14; p<0,01); perceived benefits (under age 50: F=8,18; p<0,01; over age 60: F=4,54; p<.05); mammogram-related attitude (under age 50: F=56.67; p?.001; over age 60: F=18.42; p<0.001); professional health checkups (under age 50: F=11.30; p<0.01) and luck or chance (under age 50:F=3.78; p<0.05; 50-60 age group: F=4.29; p<0.001). More specific beliefs, assessed by items from these scales, are also statistically significant (p<0.05), although only for certain age groups. Conclusions: Women's breast cancer prevention program participation related beliefs and/or attitudes differ in terms of their age

Attitudes toward motherhood and social support as predictors of emotional distress in recently diagnosed young women with cancer undergoing fertility preservation

Objective. Young women with cancer can benefit from various treatment options for fertility preservation. More work is needed to discern which factors affect psychological outcomes and the decision to undergo fertility preservation for female cancer survivors. The purpose of this study was to examine the relationship between attitudes toward motherhood, concerns about fertility, satisfaction with information received, social support and emotional distress among young women with cancer undergoing fertility preservation treatment. Method. Cross-sectional administration of instruments (semi-structured interview, Scale of Perceived Social Support, BSI-18) to 115 young women (average age 31 years) newly diagnosed with cancer. Assessment was done on the same day or day after undergoing Ovarian Tissue Cryopreservation (OTC). Results. The degree of concern reported by the women when they knew that cancer treatment might affect their reproductive capacity was high. Almost half stated that they would change the treatment-related information they received. Factors influencing their decision to receive OTC include the importance of having a child and maintaining hormonal function. Higher emotional distress was significantly associated with increase desire to have children, belief that having children is necessary for couple´s fulfillment, desire to change the information received, higher degree of concern about the possible loss of fertility, and less perceived social support. Conclusions. Both attitudes to motherhood and social support are factors that determine the emotional distress experienced by young women with cancer when faced with the possible loss of infertility. There is a need to offer fertility preservation counseling to these women

Los grupos de auto-ayuda como apoyo social en el cáncer de mama: las asociaciones de mujeres mastectomizadas de España

This paper analyzes social support role of self-help groups for women who have had breast cancer. We review, first, the background and development of these groups by empirical studies and conclude the process, dynamic and structural bases of these groups. Second, we present an Spanish empirical study with 15 self-help groups for breast cancer patients using semi-structured interviews for the leaders and questionnaires ad hoc for a sample of 110 affiliates. In line with others studies, our results confirm that self-help groups are perceived by the affiliates as an important source of emotional and informational support compared with primary groups like family and friends.Este artículo analiza el papel que juega el apoyo social para las personas enfermas de cáncer de mama a través de los grupos de auto-ayuda. Se revisan los antecedentes y desarrollo de estos grupos a partir de estudios empíricos previos, extrayendo conclusiones sobre su estructura, dinámica y procesos. Asimismo se presentan los resultados de una investigación empírica realizada en España con 15 grupos de autoayuda de mujeres con cáncer de mama. Metodológicamente se han utilizado entrevistas semiestructuradas para las presidentas de estos grupos y cuestionarios elaborados en esta investigación para una muestra de 110 afiliadas. Los resultados, en línea con los obtenidos por en otros trabajos, concluyen que estos grupos secundarios son percibidos, por las mujeres que acuden a ellos, como una fuente de apoyo de tipo emocional e informativo más relevante que otras redes naturales de apoyo como son la familia o los amigos

Effectiveness and Estimation of Cost-Effectiveness of a Group-Based Multicomponent Physical Exercise Programme on Risk of Falling and Frailty in Community-Dwelling Older Adults

This study analyses the effectiveness and cost-effectiveness of a group-based multicomponent physical exercise programme aimed at reducing the risk of falling and frailty in community-dwelling older adults. This is a pretest&ndash;posttest non-equivalent control group design, with an intervention group and a comparison group. Participants were evaluated at baseline and after 9 months. The effectiveness analyses showed significant reduction in the risk of falling (&minus;45.5%; p = 0.000) and frailty (&minus;31%; p = 0.000) after the intervention for the participants in the physical exercise programme. Moreover, these participants showed an improvement in limitations in activities of daily living, self-care ability and the use of health resources, physical performance, balance and body mass index. The cost-effectiveness analyses showed that the intervention was cost-saving and more effective than usual care scenario. A novel group-based multicomponent physical exercise programme showed to be more effective and cost-effective than usual care for older adults suffering from risk of falling and frailty