Demographic, psychological and smoking characteristics of users of an on-line smoking cessation programme in the Spanish language

AbstractObjectiveTo determine the characteristics of users of a smoking cessation programme run by the Open University of Spain (Universidad Nacional de Educación a Distancia [UNED]).MethodsWe examined the demographic, psychological and smoking characteristics of 23,763 smokers who participated in the on-line smoking cessation program of the UNED. The programme was open to any smoker, free of charge, and was fully automated and with direct access.ResultsA total of 93.5% of the users were Spaniards, with an equal percentage of participation among men and women. The mean age was 39 years. Somewhat less than half were married and had a university education. The participants smoked a mean of 19.3 cigarettes per day, showing a mid-range level of nicotine dependence according to the Heaviness of Smoking Index. The results of the Anxiety and Depression subscales of the Symptom Checklist-90-Revised (SCL-90-R) and Perceived Stress Scale were not clinically significant. In a secondary analysis of the data, we found gender differences in all the variables measured.ConclusionsThe results of this study confirm the digital divide, with lower participation among people with a lower educational level. No association was observed between stress, anxiety or depression and cigarette consumption

La utilización del mindfulness en el paciente oncológico

One of the main problems of the oncology patients is the coping with illness, through its different phases and moments. Mindfulness-Based Stress Reduction (MBSR), has been used to reduce stress and negative emotional aspects in these patients. This educational program promotes the experience of the present moment and attempts a physiological adjustment on increased emotional activation. Although controlled studies do not allow knowing the really efficacy of this program, as well as delimiting its main components, positive findings have been got support its use in the treatment of oncology patients. In addition, it is speculated about consider Mindfulness like an educational program or a clinical intervention, considering the influence of this differentiation / distinction on Mindfulness’ effects.Uno de los problemas principales del paciente oncológico es el afrontamiento de su enfermedad, en las distintas fases y momentos de ésta. Para ayudarle a reducir el estrés y los aspectos emocionales negativos se ha utilizado el Mindfulness-Based Stress Reduction (MBSR). Este programa educativo potencia la vivencia del momento presente al tiempo que procura una regulación fisiológica del exceso de activación emocional. Aunque los estudios controlados no permiten conocer la eficacia real de este programa, así como delimitar sus componentes principales, se han obtenido resultados positivos que aconseja considerarlo en el abordaje del paciente oncológico. Se especula, además, sobre su consideración como programa educativo o como intervención clínica, matizando la eficacia diferencial que esto pueda tener en sus efectos

Sobre la desensibilización sistemática. Una técnica superada o renombrada

This paper constitutes a reflection about the pioneer Systematic Desensitization (SD), which bases seem to have been assumed by more popular procedures. Al­though SD fell into oblivion; its foundations remain as part of new approaches such as the Relational Frame Theory or mindfulness and targets a wide range of disor­ders besides specific phobias. Theoretically speaking and in comparison, with other exposition techniques, SD contributes in a better way to the reduction of anxiety by: relaxation, calibration of the exposures and a long-lasting learning of an alternative response within a varied sti­mulating context that favors generalization process. Mo­reover, SD is better accepted by patients and is a flexible procedure with consolidated bases. These serve as suffi­cient arguments to revalue this technique.ResumenEn este trabajo se lleva a cabo una reflexión sobre la pionera Desensibilización Sistemática (DS), cuyos principios parecen haber sido asumidos por otros procedimientos de mayor popularidad. Aunque olvidada, los fundamentos de la DS cuentan con referencias a nuevos enfoques como la Teoría de Marcos Relacionales (RFT) o el mindfulness, así como una gran variedad de aplicaciones más allá del abordaje de las fobias específicas. Desde un punto de vista teórico y en comparación con otras técnicas de exposición, la DS contribuye de mejor manera a la reducción de la ansiedad mediante: la relajación, la presentación gradual y el aprendizaje duradero de una respuesta alternativa bajo un contexto estimular variado que favorece la generalización. Además la DS es mejor recibida por los pacientes, es un procedimiento flexible y con unas bases teóricas consolidadas, siendo estas razones suficientes para revalorar la técnica. AbstractThis paper constitutes a reflection about the pioneer Systematic Desensitization (SD), which bases seem to have been assumed by more popular procedures. Al­though SD fell into oblivion; its foundations remain as part of new approaches such as the Relational Frame Theory or mindfulness and targets a wide range of disor­ders besides specific phobias. Theoretically speaking and in comparison, with other exposition techniques, SD contributes in a better way to the reduction of anxiety by: relaxation, calibration of the exposures and a long-lasting learning of an alternative response within a varied sti­mulating context that favors generalization process. Mo­reover, SD is better accepted by patients and is a flexible procedure with consolidated bases. These serve as suffi­cient arguments to revalue this technique

Development of a self-reporting tool to obtain a Combined Index of Severity of Fibromyalgia (ICAF*)

<p>Abstract</p> <p>Background</p> <p>Fibromyalgia is a syndrome with heterogeneous symptoms. The evaluation in the clinical setting usually fails to cover the complexity of the syndrome. This study aims to determine how different aspects of fibromyalgia are inter-related when measured by means of a self-reporting tool. The objective is to develop a more complete evaluation model adjusted to the complexity and multi-dimensional nature of the syndrome.</p> <p>Methods</p> <p>Application was made of the Fibromyalgia Impact Questionnaire, the Hospital Anxiety and Depression Scale, the Brief Pain Inventory, the Fatigue Assessment Scale, the Health Assessment Questionnaire, the General Health Questionnaire (GHQ-28), the Chronic Pain Coping Inventory, the Arthritis Self-efficacy Scale and the Sleep Quality Scale. An assessment was made, on the basis of clinical interviews, case histories and specific tests, of the patient sociodemographic data, comorbidity, physical exploration and other clinical indexes. An exploratory factor analysis was made, with comparisons of the clinical index scores in extreme groups of patients.</p> <p>Results</p> <p>The ICAF composed of 59 items was obtained, offering four factors that explain 64% of the variance, and referred to as Emotional Factor (33.7%), Physical-Activity (15%), Active Coping (9%) and Passive Coping (6.3%). A t-test between the extreme scores of these factors in the 301 patients revealed statistically significant differences in occupational status, medically unexplained syndromes, number of tender points, the six-minutes walk test, comorbidity and health care costs.</p> <p>Conclusions</p> <p>This study offers a tool allowing more complete and rapid evaluation of patients with fibromyalgia. The test intrinsically evaluates the emotional aspects: anxiety and depression, and their impact upon social aspects. It also evaluates patient functional capacity, fatigue, sleep quality, pain, and the way in which the patient copes with the disease. This is achieved by means of a self-assessment questionnaire based on elements from well known tests.</p

The use of Mindfulness in the oncology patient

One of the main problems of the oncology patients is the coping with illness, through its different phases and moments. Mindfulness-Based Stress Reduction (MBSR), has been used to reduce stress and negative emotional aspects in these patients. This educational program promotes the experience of the present moment and attempts a physiological adjustment on increased emotional activation. Although controlled studies do not allow knowing the really efficacy of this program, as well as delimiting its main components, positive findings have been got support its use in the treatment of oncology patients. In addition, it is speculated about consider Mindfulness like an educational program or a clinical intervention, considering the influence of this differentiation / distinction on Mindfulness’ effects

A confirmatory study of the Combined Index of Severity of Fibromyalgia (ICAF*): factorial structure, reliability and sensitivity to change

<p>Abstract</p> <p>Background</p> <p>Fibromyalgia (FM) is a complex syndrome that affects many aspects of the patients life and it is very difficult to evaluate in clinical practice. A recent study has developed the Combined Index of Severity of Fibromyalgia (ICAF), an instrument that evaluates diverse aspects of FM and offers five indices: emotional, physical, active coping, passive coping and total. The objective of this study is to confirm the structure of the ICAF, check its test-retest reliability, assess its sensitivity to change, and compare the results obtained in a sample of patients with fibromyalgia with another sample of healthy controls.</p> <p>Methods</p> <p>A total of 232 patients took part in the study, 228 women and 4 men, with a mean age of 47.73 years of age (SD = 8.61) and a time of disease evolution since diagnosis of 4.28 years (SD = 4.03). The patients from the FM group completed the ICAF. Between one and two weeks later, they again attended the clinic and complete the 59 items on the ICAF (retest) and immediately afterwards they began treatment (according to daily clinical practice criteria). A sample of healthy subjects was also studied as a control group: 110 people were included (106 women and 4 men) with a mean age of 46.01 years of age (SD = 9.35). The study was conducted in Spain.</p> <p>Results</p> <p>The results obtained suggest that the four-factor model obtained in the previous study adequately fits the data obtained in this study. The test-retest reliability and internal consistency were all significant and show a high degree of correlation for all the factors as well as in overall score. With the exception of the passive coping factor, all the other scores, including the overall score, were sensitive to change after the therapeutic intervention. The ICAF scores of the patients with fibromyalgia compared with those of the control group were markedly different.</p> <p>Conclusions</p> <p>The findings suggest that the ICAF is a valid, reliable, sensitive to change instrument with the added advantage that it offers some additional domains (factors) that provide very valuable information regarding the most delicate aspects of the patient, which must be addressed at the time of treatment in daily clinical practice.</p

Psychological Flexibility Is Key for Reducing the Severity and Impact of Fibromyalgia

Fibromyalgia has a significant impact on the lives of patients; symptoms are influenced by psychological factors, such as psychological flexibility and catastrophizing. The objective of this study was to determine the importance of these variables in moderating the association between the severity and impact of fibromyalgia symptoms. A total of 187 patients from a general hospital population were evaluated using the Combined Index of Severity of Fibromyalgia (ICAF), the Fibromyalgia Impact Questionnaire (FIQ), the Acceptance and Action Questionnaire-II (AAQ-II), and the Pain Catastrophizing Scale (PCS). A series of multiple regression analyses were carried out using the PROCESS macro and decision tree analysis. The results show that psychological flexibility modulates the relation between severity and the impact of fibromyalgia symptoms. Catastrophism has residual importance and depends on the interaction with psychological flexibility. Interaction occurs if the severity of the disease is in transition from a mild to a moderate level and accounts for 40.1% of the variance in the sample. These aspects should be considered for evaluation and early intervention in fibromyalgia patients

Análisis de sendero de componentes de rendimiento en la calabaza

Path coefficient analysis was carried out in tropical pumpkin (Cucurbita moschata Duchesne) for yield per plant as a function of number of fruit per plant and weight per fruit, using phenotypic and genetic correlations from two diallels: one using five varieties (variety diallel) and a second using five S1 lines derived from the varieties (line diallel). A randomized complete block design with five replications was used to evaluate 15 genotypes from each diallel, not including reciprocals. Direct effects were 300 to 500% greater than indirect effects in the line diallel. In contrast, direct effects were only 17 to 68% greater than indirect effects in the variety diallel. Effects (direct and indirect) were greater (17 to 500%) when genetic correlations rather than phenotype correlations (42 to 440%) were used in the path analysis. Fruit weight showed a greater effect on yield than did number of fruit, with values between 3.2 to 4.9 times the residual effects. Fruit weight and number of fruit can be used as selection criteria to increase yield in tropical pumpkin.  El presente estudio tuvo como objetivo realizar un análisis de sendero para producción por planta en función del número de frutas por planta y el peso por fruta en dos dialélicos de calabaza (Cucurbita moschata Duchesne): uno entre cinco variedades y otro entre cinco lineas S1, originadas de las anteriores. Se utilizaron correlaciones fenotípicas tanto como correlaciones genéticas. Se utilizó un diseño en bloques completos al azar con cinco repeticiones para evaluar los 15 genotipos de cada dialelo (no se incluyeron los recíprocos). Los efectos directos resultaron mayores que los efectos indirectos en el dialélico de líneas (300% a 500%) que en el de variedades (17% a 68%). Los efectos (directos e indirectos) fueron superiores cuando se usaron las correlaciones genéticas (17% a 500%), que cuando se usaron las correlaciones fenotípicas (42% a 440%) en el análisis de sendero. El peso por fruta mostró mayor efecto directo sobre la producción que el número de frutas, con valores entre 3.2 a 4.9 veces el efecto residual. Tanto el peso por fruto como el número de frutas pueden usarse como criterios de selección para incrementar la producción en C. moschata

El cuestionario general de salud (GHQ-28) en pacientes con fibromialgia: propiedades psicométricas y adecuación

ResumenLa fibromialgia es un síndrome que incluye síntomas como dolor generalizado musculoesquelético, problemas emocionales y cognitivos, así como dificultades de adaptación. El Cuestionario General de Salud (GHQ-28) ha sido ampliamente usado, aunque apenas existen datos sobre su utilización en pacientes de fibromialgia. Se han estudiado 301 pacientes de esta patología, analizándose la bondad del cuestionario y su estructura y obteniéndose altos niveles en ansiedad (=1.5), disfunción social (=1.56) y síntomas somáticos del GHQ-28 ( .67). La fiabilidad es adecuada (α de Cronbach = .94). La estructura factorial analizada de cuatro factores se ajusta a la propuesta por los autores del cuestionario. Se concluye que el GHQ-28ha sido útil para explorar la sintomatología psicológica en los pacientes de fibromialgia.AbstractFibromyalgia is a syndrome that involves multiple symptoms, including widespread musculoskeletal pain, emotional and cognitive problems, and adjustment difficulties. The General Health Questionnaire (GHQ-28) has been widely used, even if little data exist on its use in patients with fibromyalgia. A sample of 301 patients with fibromyalgia was studied, analyzing the goodness of the questionnaire andX its structure. High anxiety levels (= 1.5), social dysfunction (= 1.56) and somatic symptoms of GHQ-28 (= 1.67) were obtained. The reliability is adequate (Cronbach's α = .94) and the factor structure of four factors analyzed conforms to that proposed by the authors of the questionnaire. The conclusion is that GHQ-28 has been useful to explore the psychological symptoms in patients with fibromyalgia