Contingential Analysis: Interbehavioral Methodology for the Applied Field

The main purpose of this chapter is to introduce contingential analysis and to generate interest on this subject. This is an interbehavioral methodology for applied field. Theoretical and philosophical foundations are briefly described at first; this was considered important because this methodology is an alternative and naturalistic way to approach professional work. Its basis is found on the interbehavioral model developed by Kantor such as on the functional taxonomy developed by Ribes and López in 1985. This system has five steps: microcontingential analysis, macrocontingential analysis, behavior origin, solution analysis, and selection, design, and application of intervention strategies; each one is explained in this text. Finally, some effective applications of the methodology are mentioned

Proposta educativa para a saúde do paciente com diabete mellitus tipo 2

Health psychology focuses on the study of the psychological processes involved in health and illness, and incorporates a wide range of activities: health promotion, illness prevention, and attention for both the sick and for people suffering the aftereffects of illness. It also plays a role in the provision of health services according to the needs of the recipients. Given the worldwide prevalence of diabetes mellitus type 2, the conditions and quality of life of people with this disease has become a public health issue that must be addressed seriously. Although the treatment of diabetes is the direct responsibility of professionals and institutions working in this area, a multidisciplinary effort would help greatly in finding a solution or improving the condition, and psychology, as a generator of knowledge that could be applied, therefore has a place in this wider working team. The objective of this research study was to design an educational proposal based on the psychological model of biological health (Ribes, 1990) to promote preventative behavior in patients with diabetes mellitus type 2.La psicología de la salud se aboca al estudio de aquellos procesos psicológicos que participan en el proceso salud-enfermedad. Comprende un plano amplio de actividades: promoción de la salud, prevención de enfermedades, atención tanto de enfermos como de personas con diversas secuelas de enfermedades y de igual manera interviene en la adecuación de los servicios de salud a las necesidades de los que los reciben. Dada la prevalencia de personas con diabetes mellitus tipo 2 en el mundo, las afecciones y la calidad de vida de quien padece esta enfermedad se han convertido en un problema de salud pública que debe ser atendido con seriedad. Si bien es cierto que la atención de la diabetes le atañe a los profesionales y a las instituciones encargados de esa dimensión, sumar esfuerzos en un nivel multidisciplinario debe favorecer en gran medida la solución o mejora de esa condición, por lo que la psicología, como generadora de conocimiento susceptible de ser aplicado, se agrega desde su dimensión al equipo de trabajo. El objetivo de esta investigación fue diseñar una propuesta educativa fundamentada en el modelo psicológico de la salud biológica (Ribes, 1990) para promover conductas de prevención en pacientes con diabetes mellitus tipo 2.A psicologia da saúde se dedica ao estudo daqueles processos psicológicos que participam do processo saúde-doença. Compreende um plano amplo de atividades: promoção da saúde, prevenção de doenças, atendimento tanto de doentes quanto de pessoas com diversas sequelas de doenças, além de intervir na adequação dos serviços de saúde às necessidades dos que os recebem. Tendo em vista a prevalência de pessoas com diabete mellitus tipo 2 no mundo, as afecções e a qualidade de vida de quem padece dessa doença se converteram num problema de saúde pública que deve ser atendido com seriedade. Embora seja certo que o atendimento da diabete corresponda aos profissionais e às instituições encarregadas dessa dimensão, somar esforços num nível multidisciplinar deve favorecer, em grande medida, a solução ou melhora dessa condição; razão pela qual a psicologia, como geradora de conhecimento suscetível de ser aplicado, se soma, sob sua dimensão, à equipe de trabalho. O objetivo desta pesquisa foi desenhar uma proposta educativa fundamentada no modelo psicológico da saúde biológica (Ribes, 1990) para promover condutas de prevenção em pacientes com diabete mellitus tipo 2

Cambios en la Dieta y en Indicadores Antropométricos de Pacientes Diabéticos a partir de un Programa Psicológico de Intervención

La diabetes tipo 2 afecta a una parte importante de la población mexicana. Adherirse a una dieta saludable es el pilar de cualquier intervención. Los conocimientos que el paciente tiene son requisito para generar otros cambios y, con este propósito, conviene estudiar estrategias didácticas en poblaciones mexicanas. En este trabajo se presenta un estudio para evaluar cambios en la dieta y en otras medidas en pacientes diabéticos a partir de un programa psicológico educativo. Utilizando un diseño pre-test post-test, se aplicó un programa para que adquirieran conocimientos sobre diabetes y nutrición a 120 pacientes diabéticos. Se encontraron cambios en todas las variables evaluadas en la dirección deseada, aunque no se logró una adherencia de 100% a la dieta recomendada. Los pacientes continuaron excedidos en su ingesta de grasas y bajos en la de verduras. Se sugiere seguir estudiando estrategias que permitan trascender del conocimiento teórico a conductas específicas saludables.Palabras claves: Diabetes, Adherencia, Conocimientos, Cambios en la Dieta.Dietary and anthropometrical changes on diabetic patients after the application of a psychological intervention program. Type 2 Diabetes affects importantly to Mexican population. Adherence to a healthy diet is the main target of any prevention or intervention plan. It is known that information is a necessary condition to acquire new habits and it is necessary to study educational strategies to reach this goal, so, on this basis, a study to evaluate changes on diabetic patients’ diets and in other variables after an educative psychological program was applied, is presented here. This program was applied within a pre-test post-test design with 120 volunteer diabetic patients. Results showed changes in all measured variables, these changes were in the planned direction, but a hundred percent adherence was not reached. Patients were still eating many fats and their diets did not include enough vegetables. To search for more effective strategies to go through theoretical knowledge to healthy eating behaviors is the suggestion of this work. Key Words: Diabetes, Adherence, Knowledge, Dietary Changes

Adherencia a la dieta en pacientes diabéticos: efectos de una intervención

The purpose of the present study was to assess the effect of an intervention program on the self-reported adherence to a prescribed diet for diabetic patients. Because of the impact and consequences of this chronic illness, it is important to make the necessary efforts in order to achieve this dietary adherence goal, since diet is one of the main bases for the treatment of diabetes. According to an interbehavioral approach, an intervention program was designed and applied to ninety diabetic patients from different Mexican public health institutions. This program was developed in three stages. The first stage consisted of a pre-test to assess body weight and habits related to daily meals. The second stage comprehended an intervention divided in two parts, the first one to provide patients with useful knowledge about diabetes and nutrition and the second one to train several behavioral techniques a post-test was applied to participants. Results showed that each intervention´s part had a positive effect on self-reported adherence to diet, and so the complete program. These results were supported by weight data. In this sense, it was found a statistically significant difference between pre and post-test values. It is suggested to continue these efforts in order to contribute on the solution of this public health problem.El presente trabajo tuvo como objetivo evaluar el efecto de un programa de intervención en la adherencia auto reportada a la dieta prescrita para pacientes diabéticos. Dado el costo y consecuencias de esta enfermedad, resulta muy importante lograr este objetivo que constituye la piedra angular del tratamiento. Desde la perspectiva interconductual, se diseñó un programa de intervención que se aplicó a 90 pacientes diabéticos captados en distintos centros de salud de la ciudad de México. El programa constó de una fase de pre-evaluación, en la que se midió el peso y se registraron prácticas alimenticias; una intervención en dos bloques, el primero educativo y el segundo en el que se entrenó en el manejo de algunas técnicas conductuales; y una fase de post-evaluación. Se encontró que cada bloque de intervención tuvo un efecto positivo en la adherencia autoreportada a la dieta y, por ende, el programa en su totalidad fue efectivo en esta muestra de pacientes. Los resultados se corroboraron con las medidas de peso en las que también se encontró una diferencia estadísticamente significativa entre el pre-test y el post-test. Se sugiere continuar buscando estrategias cada vez más efectivas para el logro de este objetivo

Psychological Barriers. Adherence to treatment: A major obstacle to reaching goals in type 2 diabetes

Type 2 diabetes treatment outcomes ultimately depend on patients and their ability to make longterm behavioural changes that support good self-care and metabolic control. Patients’ perceptions about diabetes and diabetes-related complications can have a strong influence on their emotional well-being, as well as day-to-day self-care and the quality of metabolic control. The gravity of diabetes is often underestimated, and many patients do not understand the link between poor glycaemic control and long-term complications of the disease. Similarly, people with diabetes commonly undervalue the role of lifestyle changes and pharmacological therapy in preventing future complications. Negative emotions and preconceptions about treatment can also discourage adherence to treatment plans. ‘Psychological insulin resistance’ caused by fear and concerns about insulin and daily insulin injections can discourage many patients from starting insulin therapy, even if oral agents have failed.Depression, stress and anxiety represent further obstacles to optimum self-care and the attainment of glucose goals. Healthcare professionals should endeavour to understand and accommodate these issues when setting personal treatment goals and developing plans to achieve them. Importantly, the advice and support they provide should be tailored to the unique needs of each patient. There is scope to improve outpatient consultations to ensure agreement between patients and professionals concerning issues discussed and decisions made, and this may help to improve recall and motivation to manage diabetes. Engaging patients in the goal-setting process can help to overcome potential barriers to good self-care and may increase the probability that treatment goals are achieved

Proposta educativa para a saúde do paciente com diabete mellitus tipo 2

Health psychology focuses on the study of the psychological processes involved in health and illness, and incorporates a wide range of activities: health promotion, illness prevention, and attention for both the sick and for people suffering the aftereffects of illness. It also plays a role in the provision of health services according to the needs of the recipients. Given the worldwide prevalence of diabetes mellitus type 2, the conditions and quality of life of people with this disease has become a public health issue that must be addressed seriously. Although the treatment of diabetes is the direct responsibility of professionals and institutions working in this area, a multidisciplinary effort would help greatly in finding a solution or improving the condition, and psychology, as a generator of knowledge that could be applied, therefore has a place in this wider working team. The objective of this research study was to design an educational proposal based on the psychological model of biological health (Ribes, 1990) to promote preventative behavior in patients with diabetes mellitus type 2.La psicología de la salud se aboca al estudio de aquellos procesos psicológicos que participan en el proceso salud-enfermedad. Comprende un plano amplio de actividades: promoción de la salud, prevención de enfermedades, atención tanto de enfermos como de personas con diversas secuelas de enfermedades y de igual manera interviene en la adecuación de los servicios de salud a las necesidades de los que los reciben. Dada la prevalencia de personas con diabetes mellitus tipo 2 en el mundo, las afecciones y la calidad de vida de quien padece esta enfermedad se han convertido en un problema de salud pública que debe ser atendido con seriedad. Si bien es cierto que la atención de la diabetes le atañe a los profesionales y a las instituciones encargados de esa dimensión, sumar esfuerzos en un nivel multidisciplinario debe favorecer en gran medida la solución o mejora de esa condición, por lo que la psicología, como generadora de conocimiento susceptible de ser aplicado, se agrega desde su dimensión al equipo de trabajo. El objetivo de esta investigación fue diseñar una propuesta educativa fundamentada en el modelo psicológico de la salud biológica (Ribes, 1990) para promover conductas de prevención en pacientes con diabetes mellitus tipo 2.A psicologia da saúde se dedica ao estudo daqueles processos psicológicos que participam do processo saúde-doença. Compreende um plano amplo de atividades: promoção da saúde, prevenção de doenças, atendimento tanto de doentes quanto de pessoas com diversas sequelas de doenças, além de intervir na adequação dos serviços de saúde às necessidades dos que os recebem. Tendo em vista a prevalência de pessoas com diabete mellitus tipo 2 no mundo, as afecções e a qualidade de vida de quem padece dessa doença se converteram num problema de saúde pública que deve ser atendido com seriedade. Embora seja certo que o atendimento da diabete corresponda aos profissionais e às instituições encarregadas dessa dimensão, somar esforços num nível multidisciplinar deve favorecer, em grande medida, a solução ou melhora dessa condição; razão pela qual a psicologia, como geradora de conhecimento suscetível de ser aplicado, se soma, sob sua dimensão, à equipe de trabalho. O objetivo desta pesquisa foi desenhar uma proposta educativa fundamentada no modelo psicológico da saúde biológica (Ribes, 1990) para promover condutas de prevenção em pacientes com diabete mellitus tipo 2