Concerns, Mental Health, and Quality of Life in Living Kidney Donation–Parent Donor Candidates Worry Less about Themselves

Even though the majority of living kidney donor candidates appear in good mental health and show few concerns little is known concerning the influence of the type of donor-recipient relationship on donor candidates’ specific concerns with regard to kidney donation. 136 donor candidates at Virgen del Rocío University Hospital of Seville filled in the Scale of Concerns Regarding Living Kidney Donation of whom 105 donor candidates and their corresponding recipients (105 patients with End-Stage Renal Disease) were further evaluated with regard to mental health (Hospital Anxiety and Depression Scale, Beck Depression Inventory-II) and quality of life (SF-36 Health Survey). As hypothesized recipients scored higher on depression and lower on quality of life. Donor candidates intending to donate to their children were significantly less concerned about risks of donation for themselves compared to donor candidates donating to siblings. Our findings highlight the importance of the type of donor-recipient relationship to understand specific concerns of donor candidates and optimize psychosocial assessment and support. From an evolutionary perspective parents lack of concern about their own well-being can be seen as an altruistic behavior to increase children’s fitness at the (potential) expense of their own fitness

Sida y exclusión social : alteraciones emocionales

This study analyses emotional disturbances in people infected by AIDS. The participants (105 males) were separated in the following four groups: (1) subjects with AIDS, with a parenteral drug addiction (ADVP), and who live in a condition of social exclusion (SE) (n = 30); (2) ADVP and SE subjects (n = 30); (3) SE subjects (n = 15); and (4) individuals in a condition of social adaptation (n = 30). The assessment was made by means of self-report instruments of anxiety, depression and psychopathology. Results point out that people who are in a situation of social exclusion have a similar pattern in the studied variables unlike the normal group. However, this does not show in a clear way that the same frequency of emotional alterations may exist in these groups, thus we suggest that possibly there may be particular situations which make certain exclusion groups receive more multidisciplinary intervention.El objetivo de este estudio es analizar las alteraciones emocionales más comunes en personas afectadas por el SIDA con antecedentes de drogadicción y que viven en una situación de exclusión social. La muestra está formada por 105 participantes, varones procedentes de la Comunidad Autónoma Andaluza, distribuida en cuatro grupos: (a) 30 personas con la infección SIDA, con historial de adicción a drogas vía parenteral (ADVP) y que viven en una situación de exclusión social; (b) 30 personas con historial de ADVP y en situación de exclusión social; (c) 15 personas en situación de exclusión social y (d) 30 personas en situación de adaptación social. Las medidas de evaluación utilizadas son: Entrevista semiestructurada de elaboración propia, la Escala de Ansiedad y Depresión en el Hospital (HAD) de Zigmond y Snaith (1983) y determinadas subescalas del Inventario Multiaxial Clínico MCMI-II (Millón, 1999). Los resultados indican que de forma generalizada las personas que se encuentran en una situación de exclusión social (grupos SIDA, drogadicción y pobreza) presentan puntuaciones similares en las variables estudiadas y diferentes del grupo normal, pero esto no indica de forma clara que exista la misma incidencia de alteraciones emocionales en esos grupos, por lo que se sugiere que tal vez existan determinadas situaciones que hacen que ciertos grupos de excluidos reciban una mayor intervención multidisciplinar que influya para homogeneizar los resultados

Análisis del uso de estrategias de afrontamiento en la enfermedad pulmonar obstructiva crónica (EPOC) : implicaciones conceptuales

Coping is at the first line at current research about health-illness, but it is facing a conceptual confusion that limits its efficiency. We have assessed the use of coping and the affective state in ambulatory and hospitalized Chronic obstructive pulmonary disease (COPD) patients, with three aims: a) getting of information about the use of coping and the affective states in COPD patients; b) determination of coping sensitivity levels to the stressors that configure medical situations; and c) establishment of capacity of this concept to predict the presence of emotional disorders. Our results have shown us the weakness of coping concept, now that its lack of sensitivity to the shaping items in the stressful situation and its incapacity to collect the modulating factors of the affective state; we have pointed out several explanations to this situation and proposed changes in coping evaluation and definition.El concepto de afrontamiento ocupa un lugar de primer orden en la investigación actual en el ámbito de la salud-enfermedad, pero se enfrenta a una situación de confusión conceptual que limita su operatividad. Hemos evaluado el uso de estrategias de afrontamiento y el estado afectivo en pacientes ambulatorios y hospitalizados que padecen una Enfermedad Pulmonar Obstructiva Crónica (EPOC) con un triple objetivo: a) obtener información sobre el uso de estrategias de afrontamiento y acerca del estado afectivo en los enfermos con EPOC; b) determinar los niveles de sensibilidad del concepto de Afrontamiento a los estresores que configuran las situaciones médicas; y c) establecer la capacidad de este concepto para predecir la presencia de alteraciones afectivas. Nuestros resultados nos han mostrado la debilidad del concepto de Afrontamiento, dada su falta de sensibilidad a los elementos que configuran la situación estresante y su incapacidad para recoger los factores moduladores del estado afectivo; hemos apuntado algunas explicaciones a esta situación y propuesto modificaciones en la definición y evaluación del Afrontamiento

Influencia de algunas variables médicas y psicosociales en la recuperación psicológica de los trasplantados : futuras líneas de intervención psicológica

In the present investigation we analyze the influence that some medical (type of transplanted organ and hospitalization) and psychosocial variables (period from the implant, expectations toward the illness and type of family relationships from the transplant) exercises in the psychological recovery (anxiety, depression, type of thoughts, physical self-concept and coping behaviors) of the transplant patients. To achieve these objectives we use a sample composed of 100 transplant patients: 59 of kidney, 23 of liver and 18 of heart. All of them filled a psychosocial questionnaire (sociodemographics data, medicals data, etc) and a battery of psychological instruments: state-trait anxiety inventory (Spielberger, Gorsuch y Lushene, 1982), Beck's depression inventory (Beck, Brown, Eidelson, Steer y Riskind, 1987), physical self-concept scale (Garanto, 1984) and coping behaviors questionnaire (Muñoz, 1988). After analyzing the results we find on one hand that the type of transplanted organ and the time of hospitalization after the transplant don't exercise an important influence in the psychological recovery of the transplant patients and, on the other hand that the psychological disorders of these patients increase when they enter in the hospital due to some medical complication after the heart implant (heart transplant patients), during first year (0-12 months) and from two years (>24 months) of having received the renal implant (kidney transplant patients), they have some negative expectations toward their illness and when their family relationships are worse after the transplant. From these results, we propose some strategies of psychological intervention in the order to favour an appropriate psychological evolution in the transplant patients.En la presente investigación analizamos la influencia que ejerce en la recuperación psicológica (ansiedad, depresión, tipo de pensamientos, autoconcepto físico y conductas de afrontamiento) de los trasplantados una serie de variables médicas (tipo de órgano trasplantado y hospitalización) y psicosociales (tiempo transcurrido desde el implante, expectativas hacia la enfermedad y tipo de relaciones familiares tras el trasplante). Para lograr estos objetivos empleamos una muestra constituida por 100 pacientes trasplantados: 59 de riñón, 23 de hígado y 18 de corazón. Todos completaron una encuesta psicosocial (datos sociodemográficos, médicos, etc.) y una batería de instrumentos psicológicos: cuestionario de ansiedad estado-rasgo (Spielberger, Gorsuch y Lushene, 1982), inventario de depresión de Beck (Beck, Brown, Eidelson, Steer y Riskind, 1987), escala de autoconcepto físico (Garanto, 1984) y cuestionario de conductas de afrontamiento (Muñoz, 1988). Tras analizar los resultados hallamos, por un lado, que el tipo de órgano trasplantado y el tiempo de hospitalización tras el trasplante no ejercen una influencia importante en la recuperación psicológica de los trasplantados y, por otro lado, que los desequilibrios psicológicos de estos pacientes aumentan cuando ingresan en el hospital debido a alguna complicación médica tras el implante cardíaco (trasplantados cardíacos), durante el primer año (0-12 meses) y a partir de los dos años (24 meses) de haber recibido el implante renal (trasplantados renales), si tienen unas expectativas negativas hacia su enfermedad y cuando sus relaciones familiares empeoran tras el trasplante. A partir de estos resultados, proponemos algunas estrategias de intervención psicológica con el objetivo de favorecer una adecuada evolución psicológica en los pacientes trasplantados

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Health professionals attitudes towards organ donation

En el presente artículo se realiza un estudio de revisión de la literatura sobre las actitudes del personal sanitario hacia la donación de órganos. En concreto, las disonancias entre actitudes y comportamientos y algunos factores que dificultan el proceso de la donación de órganos: ausencia de información y de conocimientos básicos, dudas sobre la muerte cerebral, evitación del contacto con los familiares del donante, creencias y sentimientos negativos, rechazo de las donaciones en vida no familiares, estrés en el personal sanitario, cantidad de tiempo y falta de concienciación en la mayoría de los hospitales por parte del personal sanitario en cuanto a la detección de donantes.The aim of these studies was the analysis of the literature pertaining to the attitudes of health care professionals towards organ donation; incongruity between attitudes and behaviors and some factors which prevent or make difficult the altruistic act of donating organs (lack of information, doubts on brain death, to avoid the contact with relatives, negative feelings, refusal donation of living, stress in doctors, amount of time and lack of awakening in hospitals for detection of donors)

Health professionals attitudes towards organ donation

En el presente artículo se realiza un estudio de revisión de la literatura sobre las actitudes del personal sanitario hacia la donación de órganos. En concreto, las disonancias entre actitudes y comportamientos y algunos factores que dificultan el proceso de la donación de órganos: ausencia de información y de conocimientos básicos, dudas sobre la muerte cerebral, evitación del contacto con los familiares del donante, creencias y sentimientos negativos, rechazo de las donaciones en vida no familiares, estrés en el personal sanitario, cantidad de tiempo y falta de concienciación en la mayoría de los hospitales por parte del personal sanitario en cuanto a la detección de donantes.The aim of these studies was the analysis of the literature pertaining to the attitudes of health care professionals towards organ donation; incongruity between attitudes and behaviors and some factors which prevent or make difficult the altruistic act of donating organs (lack of information, doubts on brain death, to avoid the contact with relatives, negative feelings, refusal donation of living, stress in doctors, amount of time and lack of awakening in hospitals for detection of donors)

Coping Strategies in Liver Transplant Recipients and Caregivers According to Patient Posttraumatic Growth

The purpose of this study was to analyze the differences in coping strategies employed by liver transplant recipients and their family members according to patient posttraumatic growth. Two matched groups of 214 liver transplant recipients and 214 family members were selected. The Posttraumatic Growth Inventory and Brief COPE were used. The most relevant results were: (1) Interactive effects in active coping, support (instrumental and emotional) and acceptance strategies, which were all used more by patients with higher growth levels, while their family members showed no differences in use of these strategies by patient growth level. Furthermore, while a low level of patient growth did not mark differences between them and their caregivers, a high level did, patients employing more active coping and support (instrumental and emotional), (2) In both groups a high level of patient growth was associated with more use of positive reframing and denial than a low one, and (3) Self-blame was employed by patients more than by their caregivers. It was concluded that a high level of posttraumatic growth in liver transplant recipients is associated with more use of healthy coping strategies, basically active coping, instrumental support, and emotional support.This study was funded by the Spanish Ministry of Economy and Competitiveness (Project PSI2014-51950-P).Peer reviewe

Trastorno de las habilidades académicas: Relación de las mismas con pautas de interacción familiar

En este trabajo se pretende evaluar algunas de las características de la estructura y perfil familiares en una muestra de 158 niños entre 7 y 13 años de edad que presentan algunos rasgos significativos de trastornos de las habilidades académicas. La finalidad de esta investigación es aislar los fenómenos de interacción propios de las familias de estos niños con el objetivo de plantear estrategias de intervención en las mismas. La información obtenida a través del Cuestionario Clínico Biográfico Infantil (C.C.B.I.) que se administra de forma sistemática en la Cátedra de Psiquiatría Infantil de la Facultad de Medicina de Sevilla, es analizada estadísticamente, lo cual permite extraer algunas conclusiones de interés y utilidad clínica.The authors of this present work seek to evaluate some characteristics of the family structure and outline, in a sample of 200 children aged between 7 and 13 years who present some significant signs of disturbance in academic abilities. The aim of this study is to isolate phenomenon with regard to interaction within the child family the objective of establishing intervention strategies. The information, obtained through the Child Biographical Clinical Questionnaire which is administered systematically in the Child Psychiatry Faculty of the Department of Medicine, Seville, will be used in the later process of statistical analyses of the data obtained and in the argument of the results, which finally allow the extraction of come interesting and useful conclusions

Health-related quality of life in non-alcoholic fatty liver disease: A cross-cultural study between Spain and the United Kingdom.

BACKGROUND: It is unclear what biopsychosocial factors influence the impact of NAFLD on health-related quality of life (HRQoL), and if these factors are equally important predictors between different nationalities. METHODS: HRQoL (CLDQ) was measured in both Southern European (Spain, n = 513) and Northern European (United Kingdom -UK-, n = 224) cohorts of patients with NAFLD in this cross-sectional study. For each cohort, participant data were recorded on histological grade of steatohepatitis, stage of fibrosis and biopsychosocial variables. Regression analysis was used to explore which of these variables predicted HRQoL. Moderated mediation models were conducted using SPSS PROCESS v3.5 macro. RESULTS: Participants with severe fibrosis reported more fatigue, systemic symptoms and worry, and lower HRQoL than those with none/mild fibrosis, regardless of place of origin. In addition, body mass index (BMI) and gender were found to be significant predictors of HRQoL in both Spanish and UK participants. Female gender was associated with worse emotional function, higher BMI and more fatigue, which predicted lower participants' HRQoL. UK participants showed more systemic symptoms and worry than Spanish participants, regardless of liver severity. The negative effects of gender on HRQoL through emotional function, BMI and fatigue were reported to a greater degree in UK than in Spanish participants. CONCLUSIONS: UK participants showed a greater impairment in HRQoL as compared to Spanish participants. Higher fibrosis stage predicted lower HRQoL, mainly in the Spanish cohort. Factors such as female gender or higher BMI contributed to the impact on HRQoL in both cohorts of patients and should be considered in future multinational intervention studies in NAFLD