2020 by Cristian Ochoa Arnedo
Psycho-oncology, 2020
Objective: This study assesses the effectiveness of face-to-face group positive psychotherapy for... more Objective: This study assesses the effectiveness of face-to-face group positive psychotherapy for cancer survivors (PPC) compared to its online adaptation, online group positive psychotherapy for cancer survivors (OPPC), which is held via videoconference. A two-arm, pragmatic RCT was conducted to examine the effects of both interventions on emotional distress, posttraumatic stress (PTSS) and posttraumatic growth (PTG) among cancer survivors and analyze attrition to treatment. Methods: Adult women with a range of cancer diagnoses were invited to participate if they experienced emotional distress at the end of their primary oncological treatment. Emotional distress, PTSS and PTG were assessed at baseline, immediately after treatment and three months after treatment. Intention-to-treat analyses were carried out using general linear mixed models to test the effect of the interventions overtime. Logistic regressions were performed to test differential adherence to treatment and retention to follow-up. Results: A total of 269 individuals participated. The observed treatment effect was significant in both modalities, PPC and OPPC. Emotional distress (b=-2.24, 95%CI=-3.15– -1.33) and PTSS (b=-3.25, 95%CI=-4.97– -1.53) decreased significantly over time, and PTG (b=3.08, 95%CI=0.38–5.78) increased significantly. Treatment gains were sustained across outcomes and over time. Analyses revealed no significant differences between modalities of treatment, after adjusting for baseline differences, finding that OPPC is as effective and engaging as PPC. Conclusions: The OPPC treatment was found to be effective and engaging for female cancer early survivors. These results open the door for psycho-oncology interventions via videoconference, which are likely to lead to greater accessibility and availability of psychotherapy.
breast, 2020
Metastatic breast cancer Premenopausal women CDK4/6 inhibitor Quality of life Hormone-receptor-po... more Metastatic breast cancer Premenopausal women CDK4/6 inhibitor Quality of life Hormone-receptor-positive /HER2-Negative a b s t r a c t Metastatic breast cancer (MBC) diagnosis in young women negatively impacts on quality of life (QoL) and daily activities, disrupting their life project and forcing them to face new psychosocial challenges. The recently published results on the improvement of the overall survival of pre-or perimenopausal women with hormone-receptor-positive, HER2-negative MBC treated with CDK4/6 inhibitors plus endocrine therapy, while preserving, and in some items improving their QoL, will change the landscape of the management of this patient population. Their extended survival and potential improvement in QoL will, therefore, modify their specific needs in terms of psychosocial support. The complexity of the care of young women with MBC is described herein, based on an extensive literature review. Further research about the specific psychosocial requirements of these women and a new multidisciplinary holistic approach is paramount to properly address their concerns and preferences. The communication with and support of their partners, parents and children is an important factor affecting the QoL of these patients. Altogether, a multidisciplinary care, open communication and personalized support is required to address the psychosocial implications of the new prognostic expectations on these patients with the incorporation of new targeted therapies.
Journal of Positive Psychology, 2020
This randomized controlled trial compared the efficacy of cognitive behavioral stress management ... more This randomized controlled trial compared the efficacy of cognitive behavioral stress management (CBSM) and positive psychotherapy in cancer (PPC) to reduce post-traumatic stress symptoms
(PTSS) and distress, and to promote post-traumatic growth (PTG) in cancer survivors. Participants were 140 adult women randomly allocated to CBSM (n = 73) or PPC (n = 67). PTSS, distress, and PTG were assessed at pre- and post-intervention, and at 3- and 12–month follow-ups. Analysis showed
PPC was more effective in decreasing PTSS (b = −7.61, p <.001) and distress (b = −3.66; p <.001) than CBSM, but neither therapy significantly increased PTG (b = 0.77, p = .76). The relational veracity of PTG and its role predicting reduced PTSS was observed only in the PPC arm. In
conclusion, PPC appears to be a valid therapeutic option for assimilating and accommodating the experience of cancer after treatment completion.
Psicooncologia, 2020
Resumen: Introducción: A pesar de que los tratamientos psico-oncológicos han demostrado su efecti... more Resumen: Introducción: A pesar de que los tratamientos psico-oncológicos han demostrado su efectividad en disminuir el malestar emocional y mejorar la calidad de vida de las personas con cáncer, aún existen numerosas barreras que limitan su acceso. La transformación a online de esta atención se plantea como una solución para aumentar la cobertura del servicio y mejorar su coste-utilidad. Objetivo: Crear un ecosistema digital de salud para reducir el impacto del cáncer, aumentando el bienestar y la calidad de vida del ciudadano con cáncer. Método: Programa dirigido a pacientes diagnosticadas de cáncer de mama en fase de supervivencia aguda. Es un programa de atención escalonada dividido en 4 niveles de intervención jerarquizados por complejidad: Nivel 1, cribado y monitorización psicosocial; Nivel 2, Campus: psicoeducación y educación sanitaria; Nivel 3, soporte psicosocial comunitario; y Nivel 4, tratamiento psicoterapéutico grupal. Resultados: En 2019, 259 mujeres fueron incluidas en el programa (39,91% de los nuevos casos de cáncer de mama en los centros participantes). Solo el 3,47% (n = 9) requirió atención clínica especializada (Nivel 4). Conclusión: El programa Iconnecta’t adopta un modelo integrado de atención psicosocial en cáncer que se adecúa a las necesidades específicas de los supervivientes. Da solución a algunas de las barreras de la atención sanitaria tradicional, democratizando el acceso a los servicios mediante el uso de tecnologías de uso común en la mayoría de ciudadanos. En un futuro próximo se prevé la implementación progresiva a otras neoplasias, junto con un ensayo clínico controlado y aleatorizado que evaluará su eficacia. Palabras clave: e-Health; atención integral; prescripción digital; cáncer de mama; psicooncología; psicología de la salud.
Background: The therapeutic role of humor and hospital clowns has become a focus of interest in r... more Background: The therapeutic role of humor and hospital clowns has become a focus of interest in recent decades. Most of the research in the area has focused on children; here, we explore the influence of clown performances on adult cancer patients, their companions, and health-care staff. Methods: Ninety-nine cancer patients and 113 companions were assessed pre-and post-interventions performed by professional clowns; 31 health professionals were asked about the possible influence of the presence of clowns in hospital on their work. Results: Patients felt that clowning performances helped to reduce their level of psychological symptoms, but not their physical symptoms. Companions reported improvements in all the psychological symptoms explored. Health professionals reported that the presence of clowns in the workplace improved their well-being. Conclusions: Clowning performances helped to improve psychological functioning in all the populations studied, especially in companions. Adult hospitals should consider promoting clowning interventions to improve general well-being.
Objective To study the impact of the spontaneous use of Internet on breast cancer patients and on... more Objective To study the impact of the spontaneous use of Internet on breast cancer patients and on their relationship with health professionals.
Methods A mixed methodology was used. Two questionnaires were designed through three focus groups, and then administered to 186 patients and 59 professionals in order to assess: (1) patients’ use of Internet for health-related information and (2) the impact of this information on patients’ psychological outcomes and on their relationship with professionals.
Results Patients spent more time looking for illness-related information after diagnosis, using interactive communities more than static information websites. Patients and professionals disagreed about the use of Internet in terms of the knowledge it provides, and its psychological impact. The main barrier reported by patients regarding the sharing of online information with their professionals was the belief that it would damage their relationship.
Conclusions Both professionals and patients have a protectionist conception of the therapeutic relationship. This attitude tends to dismiss the positive impact that the use of Internet and the new communication tools may have in cancer patients. New resources should provide an “Internet Prescription” and modes of interaction to facilitate a more open digital communication.
2019 by Cristian Ochoa Arnedo
Antecedentes y objetivo: Evaluar el malestar emocional y el nivel de complejidad de pacientes pre... more Antecedentes y objetivo: Evaluar el malestar emocional y el nivel de complejidad de pacientes presentadosal Comité de Atención Psicosocial.Materiales y métodos: Estudio pre-post con un solo grupo en pacientes con cáncer. De los 144 pacientes,27 fueron derivados por el comité a especialistas del área psicosocial, y sus niveles de malestar emocionaly de complejidad fueron revisados un mes después.Resultados: Tras ser atendidos según indicaciones del comité, los pacientes mostraron un descenso signi-ficativo de los valores en malestar emocional: la media inicial de 8 puntos en la escala visual analógica demalestar emocional descendía a 5,8 puntos. El descenso se reflejó también en los niveles de complejidad:antes de ser revisados, el 70,4% de los pacientes mostraban un alto nivel de complejidad y el 7,4%, unnivel bajo. Después de ser atendidos, los porcentajes de pacientes con alta complejidad se redujeron al48,1% en los enfermos con alta complejidad, y aumentaron al 22,3% en los de baja complejidad.Conclusiones: El comité ofrece un instrumento para derivar los casos de mayor complejidad que requierenatención preferente y multidisciplinar, permitiendo optimizar recursos, por su eficacia en la resoluciónde casos complejos.
Objectives: Online resources are changing patient-professional relationship and care delivery by ... more Objectives: Online resources are changing patient-professional relationship and care delivery by empowering patients to engage in decisions in order to cope with their illness and modify behaviors. This review analyses the psychological factors associated with spontaneous and health professional-guided internet use in cancer patients. Methods: Searches were performed in the PubMed (MEDLINE), PsycINFO, and Scopus databases. Studies were included if they involved cancer patients or focused on the relationship between cancer patients and health professionals, describing either patients' spontaneous use of interne or a guided-structured eHealth psychoso-cial intervention. Results: Seventy-seven scientific papers were finally included. Results described emotional and behavioral outcomes in cancer patients who accessed online information. Internet has long been used spontaneously not only as a source of medical information or symptom management but also for decision making or emotional and social support. Health professionals can guide internet use, providing specific web-based recommendations and developing intervention programs to better meet patients' needs, such as educational or information programs. Conclusion: Online access is a complementary form of care that physicians can provide. Patients benefit from online resources, especially when both they and their health professionals increase their engagement with online interventions such as integrated systems or online communities. KEYWORDS cancer, cancer patients, E-Health, guided internet use, oncology, psychological impact, spontaneous internet use 1 | INTRODUCTION Greater access and the standardization of new technologies have increased the number of people who use the internet as a source of health-related information. Access to this online information has been associated with a change in health behavior. Historically, transformations in the availability of information and its management have had a strong impact on how populations have defined and addressed health problems. As Porter and Porter 1 pointed out, new written sources of health-related scientific, practical, and self-help knowledge began to spread quickly in the 18th century; this made information on remedies, preventive behaviors, and healthy habits available to large amounts of the increasingly literate population.
Frontiers in Psychology, 2019
Post-traumatic stress and growth are common responses to adverse life events such as cancer. In t... more Post-traumatic stress and growth are common responses to adverse life events such as cancer. In this article, we establish how cancer becomes a "fertile land" for the emergence of stress and growth responses and analyze the main mechanisms involved. Stress-growth responses on adjusting to cancer is potentially determined by factors like the phase of the illness (e.g., initial phases vs. period of survivorship), patient's coping strategies, meaning-making, and relationships with significant others. We also review the mechanisms of constructive and adaptative stress-growth balances in cancer to study the predictors, interrelated associations, triggering mechanisms, long-term results, and specific trajectories of these two responses to cancer. Finally, we update the evidence on the role of these stress-growth associations in psychologically adjusting to cancer. Together with this evidence, we summarize preliminary results regarding the efficacy of psychotherapeutic interventions that aim to facilitate a constructive psychological balance between stress and growth in cancer patients. Recommendations for future research and gaps in knowledge on stress-growth processes in this illness are also highlighted. Researchers are encouraged to design and use psychotherapeutic interventions according to the dynamic and changeable patients' sources of stress and growth along the illness. Relevant insights are proposed to understand the inconsistency of stress-growth literature and to promote psychotherapeutic interventions to facilitate a constructive balance between these key responses in cancer.
2018 by Cristian Ochoa Arnedo
Objective: Changes perceived as both positive (eg, posttraumatic growth [PTG]) and negative (eg, ... more Objective: Changes perceived as both positive (eg, posttraumatic growth [PTG]) and negative (eg, posttraumatic stress symptoms [PTSS]) have been associated with intensive Internet use among breast cancer survivors. In this multicenter study, we analyzed the role of PTG and PTSS on the amount of time spent looking for online cancer information, its content, and its psychological impact. Methods: Posttraumatic stress symptoms and PTG were assessed in 182 breast cancer survivors by using the Post‐traumatic Stress Disorder Checklist and Post‐trau-matic Growth Inventory questionnaires. Subjects also completed a questionnaire about their behavior when looking for online illness‐related information (ie, time spent, type of contents, and psychological impact). Results: Posttraumatic stress symptoms positively correlated with the amount of time spent looking for cancer‐related information, including both medical and psycho-social content. By contrast, PTG showed no relationships with the amount of time, but with a predominant search for cancer‐related psychosocial information. The psychological impact of online information was associated with participants' levels of PTG and/or PTSS. Whereas PTG was related to a decrease of women's hope, PTSS was linked to the perception of being less conscious or inadequately informed about the illness, thereby increasing feelings of distress. Conclusions: Posttraumatic stress symptoms and PTG show relationships with the amount of time spent online, the type of information accessed online, and the psychological impact of Internet use. Health professionals should prescribe online information according to the psychological response to cancer. There is a need for professional‐led online resources to provide patients with timely information as well as support sites to facilitate psychological adjustment.
2017 by Cristian Ochoa Arnedo
En Europa, el problema de la falta de vivienda lejos de desaparecer se ha acentuado.
Europa enfre... more En Europa, el problema de la falta de vivienda lejos de desaparecer se ha acentuado.
Europa enfrenta la ambivalencia de atesorar dentro de sus fronteras los mejores ejemplos de
estados del bienestar y a la vez contemplar cómo las desigualdades sociales se acentúan y la
escasez de techo y trabajo se perpetúan.
Por otra parte, el interés por los cuidados paliativos y por facilitar una muerte digna a las personas
ha ido ganando terreno en las últimas décadas. Siendo los cuidados paliativos reconocidos
como la respuesta más ponderada, completa y satisfactoria que cabe dar a las necesidades de
asistencia que comporta la etapa terminal en la vida de un enfermo.
El desarrollo de los cuidados paliativos no ha sido homogéneo en todos los países europeos
ni en las distintas comunidades autónomas. El informe The Economist (2015) destacó recientemente
un programa pionero de Espana˜ consistente en la creación de 42 equipos de atención
psicosocial y espiritual de paciente con enfermedades avanzadas.
Uno de estos equipos ha iniciado de forma pionera un programa para atender a los pacientes
sin hogar que se encuentran en situación paliativa o con enfermedades crónicas y/o avanzadas.
Este artículo repasa la situación del sinhogarismo en Europa y Espana, ˜ con especial énfasis
en la prevalencia y en las causas de mortalidad, así como las especificidades de los cuidados
paliativos en las personas sin hogar. Finalmente, se presenta nuestra experiencia tras 2 anos ˜
trabajando como psicólogos clínicos con pacientes sin hogar
Objective: The objective of this study is to describe major findings on posttraumatic growth (PTG... more Objective: The objective of this study is to describe major findings on posttraumatic growth (PTG) in cancer, by analyzing its various definitions, assessment tools, and examining its main psychological and clinical correlates. Methods: A search in relevant databases (PsycINFO, Pubmed, ProQuest, Scopus, and Web of Science) was performed using descriptors related to the positive reactions in cancer. Articles were screened by title, abstract, and full text. Results: Seventy‐two met the inclusion criteria. Most articles (46%) focused on breast cancer, used the PTG inventory (76%), and had a cross‐sectional design (68%). The PTG resulted inversely associated with depressive and anxious symptoms and directly related to hope, optimism, spirituality, and meaning. Illness‐related variables have been poorly investigated compared to psychological ones. Articles found no relationship between cancer site, cancer surgery, cancer recurrence, and PTG. Some correlations emerged with the elapsed time since diagnosis, type of oncological treatment received, and cancer stage. Only few studies differentiated illness‐ related–life‐threatening stressors from other forms of trauma, and the potentially different mechanisms connected with PTG outcome in cancer patients. Conclusions: The evaluation of PTG in cancer patients is worthy, because it may promote a better adaption to the illness. However, many investigations do not explicitly refer to the medical nature of the trauma, and they may have not completely captured the full spectrum of positive reactions in cancer patients. Future research should better investigate issues such as health attitudes; the risks of future recurrences; and the type, quality, and efficacy of medical treatments received and their influence on PTG in cancer patients.
Background/Objective: There is increasing evidence that positive life changes, such as post-traum... more Background/Objective: There is increasing evidence that positive life changes, such as post-traumatic growth (PTG), can result from the experience of coping with cancer. However, no interventions have been specifically designed to facilitate the development of PTG in cancer. In this article, we describe and assess the results of Positive Psychotherapy for Cancer (PPC) survivors. It aims to facilitate PTG as a way of achieving significant reductions in the symptoms of emotional distress and posttraumatic stress. In addition, the corroboration of this PTG facilitation is assessed using interpersonal indicators. Method: We allocated 126 consecutive survivors of cancer with high levels of emotional distress and who were seeking psychological support to either an experimental group (PPC) or a waiting list group. Results: The PPC group obtained significantly better results after treatment than the control group, showing reduced distress, decreased posttraumatic symptoms, and increased PTG. The benefits were maintained at 3 and 12 months' follow-up. Participants' PTG was correlated to the PTG that their significant others attributed to them, corroborating PTG facilitation. Conclusions: PPC appears to promote significant long-term PTG and can reduce emotional distress and posttraumatic stress in cancer survivors. In addition, PTG facilitation induced by PPC is corroborated by significant others.
La aparición de Internet y la generalización de su uso a partir de la década de los noventa han t... more La aparición de Internet y la generalización de su uso a partir de la década de los noventa han transformado la red en una de las principales fuentes de información sanitaria, especialmente en el ámbito oncológico. En la literatura científica y en nuestro actual contexto sociocultural se cuestiona si esta facilitación del acceso a información ha transformado positivamente la interacción paciente-salud y paciente-profesional sanitario. En la interacción paciente-salud, el uso de Internet podría promover que los usuarios fueran más proactivos y responsables en la mejora de su bienestar y calidad de vida. En la relación paciente-profesional, Internet ofre- cería a los profesionales sanitarios nuevas formas de empoderamiento facilitando la autonomía del paciente, su implicación en la toma de decisiones, autocuidado y adhesión a tratamientos. Sin embargo, Internet puede plantear nuevos problemas al poner a disposición del paciente una información que quizá no sabe o no quiere gestionar, con potencial para generarle mayor confusión o malestar y afectar a la relación de confianza entre profesional sanitario-paciente. Esta revisión bibliográfica analiza el impacto de Internet en cáncer en términos de oportunidad o conflicto con objeto de determinar su potencial terapéutico.
Resumen Antecedentes/Objetivo: La evidencia científica muestra la importante presencia de cam-bio... more Resumen Antecedentes/Objetivo: La evidencia científica muestra la importante presencia de cam-bios vitales positivos, como el crecimiento postraumático (CPT), tras afrontar un cáncer. Sin embargo, ninguna intervención ha sido específicamente diseñada para facilitar el CPT en cáncer. En este artículo, describimos y evaluamos los resultados de la Psicoterapia Positiva dirigida a supervivientes de Cáncer (PPC), diseñada para facilitar el CPT como vía para reducir el malestar emocional y estrés postraumático. Utilizamos indicadores interpersonales para validar la autenticidad del CPT. Método: Ciento veintiséis supervi-vientes de cáncer con elevados niveles de malestar emocional fueron consecutivamente asignados al grupo experimental (PPC) o al grupo de lista de espera. Resultados: El grupo de PPC obtuvo significativamente mejores resultados después del tratamiento que el grupo control, mostrando una reducción del malestar psicológico, de los síntomas de estrés postraumático y un incremento del CPT. Los beneficios se mantuvieron a los 3 y 12 meses. El CPT fue corroborado por los seres queridos de los participantes. Conclusiones: La PPC parece promover de forma significativa el CPT y reduce el malestar emocional y el estrés postraumático en supervivientes de cáncer. Además, la facilitación de CPT indu-cido por la PPC es corroborada por los seres queridos.
En las últimas décadas se ha impulsado desde la Psicología Positiva (PsiPos) el estudio científic... more En las últimas décadas se ha impulsado desde la Psicología Positiva (PsiPos) el estudio científico de los cambios vitales positivos tras un cáncer, integrándolos con los cambios negativos, desde un mismo marco de experiencia humana. Se han diseñado intervenciones novedosas que han priorizado vías de reducción del malestar emocional y la psicopatología en cáncer desde la facilitación de un funcionamiento psicológico positivo con resultados prometedores. Se realiza una revisión e integración teórica de los constructos de la PsiPos encontrados en bases de datos relevantes (Psycinfo, Pubmed, Web of Science, Scopus, entre otros) que se han relacionado con los cambios vitales positivos tras un cáncer y su potencial terapéutico. Por último, se describe un resumen del programa de psico- terapia positiva en cáncer apuntando las estrategias terapéuticas facilitadoras de estos cambios positivos. Los cambios vitales positi- vos tras pasar por un cáncer son más la norma que la excepción. Estos cambios juegan un importante papel en la adaptación psicosocial, adherencia a los tratamientos oncológicos, bienestar y calidad de vida. Programas de tratamiento psicológico basados en la PsiPos tienen resultados prometedores en cáncer que complementan y pueden mejorar los resultados de programas tradiciona- les de control o manejo de estrés.
2016 by Cristian Ochoa Arnedo
Resumen En esta revisión nos proponemos realizar una actualización acerca de tres aspectos que so... more Resumen En esta revisión nos proponemos realizar una actualización acerca de tres aspectos que son objeto de interés y/o controversia en el campo de las adicciones en Oncología. En primer lugar nos centraremos en el papel del consumo de sustancias como factor de riesgo tanto en el desar-rollo como en la evolución del cáncer. En el momento actual existen datos contrastados acerca de tabaco y alcohol, pero es menos conocido el posible papel de otras drogas como la mari-huana o los opioides. Estudios recientes muestran resultados interesantes acerca de estas dro-gas. En segundo lugar revisaremos un problema de interés creciente en Oncología, el llamado consumo aberrante de opioides prescritos médicamente. Se trata de un concepto descrito en dolor crónico no oncológico y actualmente, queda pendiente delimitar su prevalencia y carac-terísticas específicas en los pacientes oncológicos. Finalmente discutiremos el posible papel de la marihuana en el tratamiento de síntomas asociados al cáncer o de los efectos secundarios de los tratamientos antineoplásicos. Se trata de un tema de gran complejidad y los resultados obtenidos de la investigación realizada hasta la fecha están probablemente sesgados por aspec-tos no científicos como las limitaciones legales.
This integrative review aimed to analyze the research into positive psychological functioning aft... more This integrative review aimed to analyze the research into positive psychological functioning after breast cancer, and to integrate the most relevant findings relating to sociodemographic, medical and psycho-social factors. Relevant outcomes were identified from electronic databases (Medline, PsycINFO, Web of Science, Scopus, Cochrane, CINAHL, and Wiley Online Library) up to July 2015. A Google search was performed to identify unindexed literature. Dissertations and theses were searched on Proquest Dissertations and Theses, DIALNET and TDX. Selection criteria included empirical studies assessing relationships between breast cancer and positive functioning, without restrictions on type of participants. In total, 134 studies met the inclusion criteria. The sociodemographic, medical, and psychosocial characteristics associated with well-being, posttraumatic growth, finding benefit and meaning were being young, undergoing chemotherapy, and having social support. The last two of these characteristics were time-oriented. The culture of the different samples and positive dispositional characteristics like optimism had an influence on the women's coping styles. Socioeconomic status and level of education were also associated with positive psychological functioning. The perceived impact of breast cancer on patient, as well as the perceived support from significant others can result in better functioning in women with breast cancer. The results highlight that oncology health professionals should take into account not only the individual and medical characteristics, but also the stage of the oncological process and the psychosocial environment of patients in order to promote their positive functioning.
2015 by Cristian Ochoa Arnedo
nFundamento y objetivo: Tener una predisposición hereditaria al cáncer puede asociarse a un impac... more nFundamento y objetivo: Tener una predisposición hereditaria al cáncer puede asociarse a un impactopsicológico. Uno de los objetivos del consejo genético es favorecer la adaptación psicológica a la nuevasituación, siendo necesarios instrumentos validados en este contexto. Por ser el autoconcepto un buenindicador de adaptación a la enfermedad o al riesgo de tenerla, y una variable relevante en oncología, elobjetivo es adaptar culturalmente al castellano y validar la BRCA Self-Concept Scale.Material y método: Ciento sesenta y cinco portadoras de mutación en los genes BRCA respondieron alcuestionario previamente sometido a un proceso de traducción-retrotraducción, y a la Escala de Preocu-pación por el Cáncer (EPC) como medida de validez convergente. Se valoró la estructura del cuestionariomediante una prueba de expertos y un análisis factorial confirmatorio (AFC), se calculó el de Cronbachde las 3 subescalas (Estigma, Vulnerabilidad y Control), y se correlacionaron con la EPC.Resultados: La prueba de expertos y el AFC no confirman la estructura original del cuestionario. El modeloreespecificado (con los ítems 10 y 13 en Vulnerabilidad) muestra mejor ajuste: comparative fit index0,973; Tucker-Lewis index 0,968; root mean square error of approximation 0,067. El de Cronbach es de0,83 para Estigma, de 0,84 para Vulnerabilidad, y de 0,61 para Control. Se encuentra evidencia de validezconvergente con la EPC (rho de Spearman 0,631 para Estigma, 0,683 para Vulnerabilidad, y −0,363 paraControl; p < 0,001).Conclusiones: Los resultados apoyan la validez de la escala modificada de autoconcepto BRCA, siendouna medida potencialmente útil para valorar la adaptación a tener una alta predisposición hereditaria alcáncer.
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2020 by Cristian Ochoa Arnedo
(PTSS) and distress, and to promote post-traumatic growth (PTG) in cancer survivors. Participants were 140 adult women randomly allocated to CBSM (n = 73) or PPC (n = 67). PTSS, distress, and PTG were assessed at pre- and post-intervention, and at 3- and 12–month follow-ups. Analysis showed
PPC was more effective in decreasing PTSS (b = −7.61, p <.001) and distress (b = −3.66; p <.001) than CBSM, but neither therapy significantly increased PTG (b = 0.77, p = .76). The relational veracity of PTG and its role predicting reduced PTSS was observed only in the PPC arm. In
conclusion, PPC appears to be a valid therapeutic option for assimilating and accommodating the experience of cancer after treatment completion.
Methods A mixed methodology was used. Two questionnaires were designed through three focus groups, and then administered to 186 patients and 59 professionals in order to assess: (1) patients’ use of Internet for health-related information and (2) the impact of this information on patients’ psychological outcomes and on their relationship with professionals.
Results Patients spent more time looking for illness-related information after diagnosis, using interactive communities more than static information websites. Patients and professionals disagreed about the use of Internet in terms of the knowledge it provides, and its psychological impact. The main barrier reported by patients regarding the sharing of online information with their professionals was the belief that it would damage their relationship.
Conclusions Both professionals and patients have a protectionist conception of the therapeutic relationship. This attitude tends to dismiss the positive impact that the use of Internet and the new communication tools may have in cancer patients. New resources should provide an “Internet Prescription” and modes of interaction to facilitate a more open digital communication.
2019 by Cristian Ochoa Arnedo
2018 by Cristian Ochoa Arnedo
2017 by Cristian Ochoa Arnedo
Europa enfrenta la ambivalencia de atesorar dentro de sus fronteras los mejores ejemplos de
estados del bienestar y a la vez contemplar cómo las desigualdades sociales se acentúan y la
escasez de techo y trabajo se perpetúan.
Por otra parte, el interés por los cuidados paliativos y por facilitar una muerte digna a las personas
ha ido ganando terreno en las últimas décadas. Siendo los cuidados paliativos reconocidos
como la respuesta más ponderada, completa y satisfactoria que cabe dar a las necesidades de
asistencia que comporta la etapa terminal en la vida de un enfermo.
El desarrollo de los cuidados paliativos no ha sido homogéneo en todos los países europeos
ni en las distintas comunidades autónomas. El informe The Economist (2015) destacó recientemente
un programa pionero de Espana˜ consistente en la creación de 42 equipos de atención
psicosocial y espiritual de paciente con enfermedades avanzadas.
Uno de estos equipos ha iniciado de forma pionera un programa para atender a los pacientes
sin hogar que se encuentran en situación paliativa o con enfermedades crónicas y/o avanzadas.
Este artículo repasa la situación del sinhogarismo en Europa y Espana, ˜ con especial énfasis
en la prevalencia y en las causas de mortalidad, así como las especificidades de los cuidados
paliativos en las personas sin hogar. Finalmente, se presenta nuestra experiencia tras 2 anos ˜
trabajando como psicólogos clínicos con pacientes sin hogar
2016 by Cristian Ochoa Arnedo
2015 by Cristian Ochoa Arnedo
(PTSS) and distress, and to promote post-traumatic growth (PTG) in cancer survivors. Participants were 140 adult women randomly allocated to CBSM (n = 73) or PPC (n = 67). PTSS, distress, and PTG were assessed at pre- and post-intervention, and at 3- and 12–month follow-ups. Analysis showed
PPC was more effective in decreasing PTSS (b = −7.61, p <.001) and distress (b = −3.66; p <.001) than CBSM, but neither therapy significantly increased PTG (b = 0.77, p = .76). The relational veracity of PTG and its role predicting reduced PTSS was observed only in the PPC arm. In
conclusion, PPC appears to be a valid therapeutic option for assimilating and accommodating the experience of cancer after treatment completion.
Methods A mixed methodology was used. Two questionnaires were designed through three focus groups, and then administered to 186 patients and 59 professionals in order to assess: (1) patients’ use of Internet for health-related information and (2) the impact of this information on patients’ psychological outcomes and on their relationship with professionals.
Results Patients spent more time looking for illness-related information after diagnosis, using interactive communities more than static information websites. Patients and professionals disagreed about the use of Internet in terms of the knowledge it provides, and its psychological impact. The main barrier reported by patients regarding the sharing of online information with their professionals was the belief that it would damage their relationship.
Conclusions Both professionals and patients have a protectionist conception of the therapeutic relationship. This attitude tends to dismiss the positive impact that the use of Internet and the new communication tools may have in cancer patients. New resources should provide an “Internet Prescription” and modes of interaction to facilitate a more open digital communication.
Europa enfrenta la ambivalencia de atesorar dentro de sus fronteras los mejores ejemplos de
estados del bienestar y a la vez contemplar cómo las desigualdades sociales se acentúan y la
escasez de techo y trabajo se perpetúan.
Por otra parte, el interés por los cuidados paliativos y por facilitar una muerte digna a las personas
ha ido ganando terreno en las últimas décadas. Siendo los cuidados paliativos reconocidos
como la respuesta más ponderada, completa y satisfactoria que cabe dar a las necesidades de
asistencia que comporta la etapa terminal en la vida de un enfermo.
El desarrollo de los cuidados paliativos no ha sido homogéneo en todos los países europeos
ni en las distintas comunidades autónomas. El informe The Economist (2015) destacó recientemente
un programa pionero de Espana˜ consistente en la creación de 42 equipos de atención
psicosocial y espiritual de paciente con enfermedades avanzadas.
Uno de estos equipos ha iniciado de forma pionera un programa para atender a los pacientes
sin hogar que se encuentran en situación paliativa o con enfermedades crónicas y/o avanzadas.
Este artículo repasa la situación del sinhogarismo en Europa y Espana, ˜ con especial énfasis
en la prevalencia y en las causas de mortalidad, así como las especificidades de los cuidados
paliativos en las personas sin hogar. Finalmente, se presenta nuestra experiencia tras 2 anos ˜
trabajando como psicólogos clínicos con pacientes sin hogar
functioning; however, the role of dopamine (DA) in the executive profile of PG remains unclear. The aim of this study was to identify whether the
DRD2/ANKK1 Taq1A-rs1800497 and the DAT1-40 bp VNTR polymorphisms are associated with cognitive flexibility (measured by Wisconsin Card Sorting
Test (WCST) and Trail Making Test (TMT)) and inhibition response (measured by Stroop Color and Word Test (SCWT)), in a clinical sample of 69 PG
patients. Our results showed an association between DA functioning and cognitive flexibility performance. The Taq1A A1+ (A1A2/A1A1) genotype
was associated with poorer TMT performance (p < 0.05), while DAT1 9-repeat homozygotes displayed better WCST performance (p < 0.05) than either
10-repeat homozygotes or heterozygotes. We did not find any association between the DRD2 or DAT1 polymorphisms and the inhibition response. These
results suggested that pathological gamblers with genetic predispositions toward lower availability of DA and D2 receptor density are at a higher risk
of cognitive flexibility difficulties. Future studies should aim to shed more light on the genetic mechanisms underlying the executive profile in PG.