Justificación: La decisión sobre la alternativa terapéutica más conveniente, que corresponde al p... more Justificación: La decisión sobre la alternativa terapéutica más conveniente, que corresponde al paciente asesorado por el equipo sanitario, se hace especialmente difícil en casos del mal pronóstico. Pacientes: Paciente joven con tumor cerebral, reintervenido en diversas ocasiones, al que se detecta una recidiva. Re¬sultados: En contra de la opinión del equipo multidisciplinar, el paciente decide someterse a una reintervención, falleciendo a los cuatro meses presentando una calidad de vida aceptable. Conclusiones: Se plantea la necesidad, a través de un counselling adecuado, de permitir que el paciente escoja el resultado clínico preferido tras la transmisión clara de las distintas consecuencias de cada decisión y de la probabilidad de que cada una de ellas ocurra, evitando el uso de términos confusos, como la descripción técnica de procedimientos y las sugerencias globales sobre las decisiones. Se enfatiza el respeto a la autonomía del paciente, bajo condiciones de no maleficencia.T...
RESUMEN En los últimos cien años se ha producido un gran cambio en los modelos de enfermedad mort... more RESUMEN En los últimos cien años se ha producido un gran cambio en los modelos de enfermedad mortal. A principios de siglo las principales causas de muerte entre la población de los países desarrollados eran sobre todo enfermedades infecciosas con un desenlace fatal en un tiempo breve. Los avances tecnológicos, médicos y farmacéuticos han propiciado que el número de muertes por estos trastornos haya descendido, mientras que, paralelamente se ha producido un incremento en el índice de enfermedades de curso crónico y con frecuencia asistencia en la etapa terminal, como cáncer, SIDA, etc. La fase final de la vida de una persona conlleva habitualmente alteraciones sociales, físicas y psicológicas en los propios pacientes, su sistema familiar y el entorno en el que estos están inmersos, cambiando profundamente la vida del enfermo y todo su sistema familiar. Aunque los distintos elementos que configuran un sistema interactúan y producen influencias mutuas, consideramos que un análisis en ...
Los estilos de apego pueden estar relacionados con alteraciones psicopatologicas en la adolescenc... more Los estilos de apego pueden estar relacionados con alteraciones psicopatologicas en la adolescencia. En el presente trabajo se estudio la relacion entre la psicopatologia y el apego en la adolescencia, asi como la influencia del genero en estas variables. La muestra estaba compuesta por 88 adolescentes de entre 14 y 16 anos. La psicopatologia se evaluo con el cuestionario SCL-90-R (Derogatis, 2002) y los estilos de apego mediante la Escala de Estilos de Apego (Casullo y Fernandez, 2005). Los resultados observados indican que las mujeres presentan mayores niveles de psicopatologia y mayor tendencia a presentar estilos de apego inseguros. Los estilos de apego inseguros se relacionan con mayor nivel de psicopatologia en ambos generos.
The aim of current research is to present the Spanish version of the DAP-R, using confirmatory te... more The aim of current research is to present the Spanish version of the DAP-R, using confirmatory techniques. The sample was composed of 286 nursing undergraduate students. The confirmatory factor analysis tested offered an appropriate overall fit, internal consistency of the subscales was adequate, and most of the correlations among the DAP-R and the CL-FODS dimensions were statistically significant and, in the direction, expected. Conclusions pointed out: (1) The appropriate psychometric properties of the DAP-R when used in Spanish nurses’ sample, and (2) the importance of three concrete death attitudes for professionals’ well-being: fear of death, escape acceptance and neutral acceptance. *Correspondence: Enrique Sáez, MA, Catholic University of Valencia, Carrer de Quevedo, 2, 46001, Valencia (Spain), Telephone: +34 963637412. Received: 15 November 2020; Accepted: 08 December 2020
We present a research system with administration norms included. This system was used in a multic... more We present a research system with administration norms included. This system was used in a multicentric study on 371 terminal patients (314 oncologic and 57 AIDS). This work was carried out simultaneously in 15 hospitals (13 Spanish and 2 Latin American). The main object of this paper is to provide other researchers with a model (that of course can be improved) to serve as a basis for further research, thus helping to construct new research instruments. Our research has shown that one can attain interesting results using modest resources.
ABSTRACTObjective:The Demoralization Scale (DS) is the most widely used measure for assessing dem... more ABSTRACTObjective:The Demoralization Scale (DS) is the most widely used measure for assessing demoralization. Following the recent clamor for brief assessment tools, and taking into account that demoralization has proved to be a symptom that needs to be controlled and treated in the palliative care setting, a shorter scale is needed. The aim of the present research is to introduce and evaluate the Short Demoralization Scale (SDS).Method:We employed a cross-sectional design that included a survey of 226 Spanish palliative care patients from the Hospital General Universitario de Valencia. We employed the SDS, the DS, and the Hospital Anxiety and Depression Scale (HADS).Results:The confirmatory factor analysis supported the one-factor structure of the SDS (χ2(5) = 12.915; p = 0.024; CFI = 0.999; RMSEA = 0.084; CI95% = [0.028, 0.141]). The reliability was found to be appropriate, with a value of Cronbach's alpha (α) equal to 0.920. A cutoff criterion of 10 was established, which fav...
Objective:Several studies have successfully tested psychosocial interventions in palliative care ... more Objective:Several studies have successfully tested psychosocial interventions in palliative care patients. Counseling is the technique most often employed. Dignity therapy (DT) has recently emerged as a tool that can be utilized to address patients' needs at the end of life. The aims of our study were to examine the effects of DT and counseling and to offer useful information that could be put into practice to better meet patients' needs.Method:We developed a pilot randomized controlled trial at the Home Care Unit of the General University Hospital of Valencia (Spain). Some 70 patients were assigned to two therapy groups. The measurement instruments employed included the Patient Dignity Inventory (PDI), the Hospital Anxiety and Depression Scale (HADS), the Brief Resilient Coping Scale (BRCS), the GES Questionnaire, the Duke–UNC-11 Functional Social Support Questionnaire, and two items from the EORTC Quality of Life C30 Questionnaire (EORTC–QLQ–C30).Results:The results of rep...
In this study, we analyzed the relationships among clinical, emotional, social, and spiritual dim... more In this study, we analyzed the relationships among clinical, emotional, social, and spiritual dimensions of patients with advanced illness. It was a cross-sectional study, with a sample of 108 patients in an advanced illness situation attended by palliative care teams. Statistically significant correlations were found between some dimensions of spirituality and poor symptomatic control, resiliency, and social support. In the structural model, three variables predicted spirituality: having physical symptoms as the main source of discomfort, resiliency, and social support. This work highlights the relevance of the relationships among spirituality and other aspects of the patient at the end of life.
ABSTRACTObjective:This study aimed to develop a new and brief instrument to be employed in dignit... more ABSTRACTObjective:This study aimed to develop a new and brief instrument to be employed in dignity measurement, one based on the perceptions of patients, relatives, and professionals about dignity.Method:Surveys of patients receiving palliative care, family caregivers, and palliative care professionals were first carried out (sample 1). In the second step, palliative care patients were surveyed with a pilot questionnaire (sample 2). Finally, a survey design was used to assess patients admitted into a home care unit (sample 3). Sample 1 included 78 subjects, including patients, family caregivers, and professionals. Some 20 additional palliative patients participated in sample 2. Finally, 70 more patients admitted to a home care unit participated were surveyed (sample 3). Together with the Palliative Patients' Dignity Scale (PPDS), our survey included other measures of dignity, anxiety, depression, resilient coping, quality of life, spirituality, and social support.Results:After a...
This study evaluated the effectiveness of a psychological intervention in amyotrophic lateral scl... more This study evaluated the effectiveness of a psychological intervention in amyotrophic lateral sclerosis patients, consisting of four semi-structured sessions of cognitive behavioural therapy combined with counselling techniques. An intervention group and a control group were established. The Hospital Anxiety and Depression Scale was used to assess levels of anxiety and depression. In total, fifty-four patients took part. Prior to the intervention, the intervention group displayed rates of 63.3 and 36.7 per cent for anxiety and depression, respectively, falling to 16.7 and 10.0 per cent afterwards. The psychological intervention demonstrated potential for the reduction of levels of anxiety and depression in amyotrophic lateral sclerosis patients.
Justificación: La decisión sobre la alternativa terapéutica más conveniente, que corresponde al p... more Justificación: La decisión sobre la alternativa terapéutica más conveniente, que corresponde al paciente asesorado por el equipo sanitario, se hace especialmente difícil en casos del mal pronóstico. Pacientes: Paciente joven con tumor cerebral, reintervenido en diversas ocasiones, al que se detecta una recidiva. Re¬sultados: En contra de la opinión del equipo multidisciplinar, el paciente decide someterse a una reintervención, falleciendo a los cuatro meses presentando una calidad de vida aceptable. Conclusiones: Se plantea la necesidad, a través de un counselling adecuado, de permitir que el paciente escoja el resultado clínico preferido tras la transmisión clara de las distintas consecuencias de cada decisión y de la probabilidad de que cada una de ellas ocurra, evitando el uso de términos confusos, como la descripción técnica de procedimientos y las sugerencias globales sobre las decisiones. Se enfatiza el respeto a la autonomía del paciente, bajo condiciones de no maleficencia.T...
RESUMEN En los últimos cien años se ha producido un gran cambio en los modelos de enfermedad mort... more RESUMEN En los últimos cien años se ha producido un gran cambio en los modelos de enfermedad mortal. A principios de siglo las principales causas de muerte entre la población de los países desarrollados eran sobre todo enfermedades infecciosas con un desenlace fatal en un tiempo breve. Los avances tecnológicos, médicos y farmacéuticos han propiciado que el número de muertes por estos trastornos haya descendido, mientras que, paralelamente se ha producido un incremento en el índice de enfermedades de curso crónico y con frecuencia asistencia en la etapa terminal, como cáncer, SIDA, etc. La fase final de la vida de una persona conlleva habitualmente alteraciones sociales, físicas y psicológicas en los propios pacientes, su sistema familiar y el entorno en el que estos están inmersos, cambiando profundamente la vida del enfermo y todo su sistema familiar. Aunque los distintos elementos que configuran un sistema interactúan y producen influencias mutuas, consideramos que un análisis en ...
Los estilos de apego pueden estar relacionados con alteraciones psicopatologicas en la adolescenc... more Los estilos de apego pueden estar relacionados con alteraciones psicopatologicas en la adolescencia. En el presente trabajo se estudio la relacion entre la psicopatologia y el apego en la adolescencia, asi como la influencia del genero en estas variables. La muestra estaba compuesta por 88 adolescentes de entre 14 y 16 anos. La psicopatologia se evaluo con el cuestionario SCL-90-R (Derogatis, 2002) y los estilos de apego mediante la Escala de Estilos de Apego (Casullo y Fernandez, 2005). Los resultados observados indican que las mujeres presentan mayores niveles de psicopatologia y mayor tendencia a presentar estilos de apego inseguros. Los estilos de apego inseguros se relacionan con mayor nivel de psicopatologia en ambos generos.
The aim of current research is to present the Spanish version of the DAP-R, using confirmatory te... more The aim of current research is to present the Spanish version of the DAP-R, using confirmatory techniques. The sample was composed of 286 nursing undergraduate students. The confirmatory factor analysis tested offered an appropriate overall fit, internal consistency of the subscales was adequate, and most of the correlations among the DAP-R and the CL-FODS dimensions were statistically significant and, in the direction, expected. Conclusions pointed out: (1) The appropriate psychometric properties of the DAP-R when used in Spanish nurses’ sample, and (2) the importance of three concrete death attitudes for professionals’ well-being: fear of death, escape acceptance and neutral acceptance. *Correspondence: Enrique Sáez, MA, Catholic University of Valencia, Carrer de Quevedo, 2, 46001, Valencia (Spain), Telephone: +34 963637412. Received: 15 November 2020; Accepted: 08 December 2020
We present a research system with administration norms included. This system was used in a multic... more We present a research system with administration norms included. This system was used in a multicentric study on 371 terminal patients (314 oncologic and 57 AIDS). This work was carried out simultaneously in 15 hospitals (13 Spanish and 2 Latin American). The main object of this paper is to provide other researchers with a model (that of course can be improved) to serve as a basis for further research, thus helping to construct new research instruments. Our research has shown that one can attain interesting results using modest resources.
ABSTRACTObjective:The Demoralization Scale (DS) is the most widely used measure for assessing dem... more ABSTRACTObjective:The Demoralization Scale (DS) is the most widely used measure for assessing demoralization. Following the recent clamor for brief assessment tools, and taking into account that demoralization has proved to be a symptom that needs to be controlled and treated in the palliative care setting, a shorter scale is needed. The aim of the present research is to introduce and evaluate the Short Demoralization Scale (SDS).Method:We employed a cross-sectional design that included a survey of 226 Spanish palliative care patients from the Hospital General Universitario de Valencia. We employed the SDS, the DS, and the Hospital Anxiety and Depression Scale (HADS).Results:The confirmatory factor analysis supported the one-factor structure of the SDS (χ2(5) = 12.915; p = 0.024; CFI = 0.999; RMSEA = 0.084; CI95% = [0.028, 0.141]). The reliability was found to be appropriate, with a value of Cronbach's alpha (α) equal to 0.920. A cutoff criterion of 10 was established, which fav...
Objective:Several studies have successfully tested psychosocial interventions in palliative care ... more Objective:Several studies have successfully tested psychosocial interventions in palliative care patients. Counseling is the technique most often employed. Dignity therapy (DT) has recently emerged as a tool that can be utilized to address patients' needs at the end of life. The aims of our study were to examine the effects of DT and counseling and to offer useful information that could be put into practice to better meet patients' needs.Method:We developed a pilot randomized controlled trial at the Home Care Unit of the General University Hospital of Valencia (Spain). Some 70 patients were assigned to two therapy groups. The measurement instruments employed included the Patient Dignity Inventory (PDI), the Hospital Anxiety and Depression Scale (HADS), the Brief Resilient Coping Scale (BRCS), the GES Questionnaire, the Duke–UNC-11 Functional Social Support Questionnaire, and two items from the EORTC Quality of Life C30 Questionnaire (EORTC–QLQ–C30).Results:The results of rep...
In this study, we analyzed the relationships among clinical, emotional, social, and spiritual dim... more In this study, we analyzed the relationships among clinical, emotional, social, and spiritual dimensions of patients with advanced illness. It was a cross-sectional study, with a sample of 108 patients in an advanced illness situation attended by palliative care teams. Statistically significant correlations were found between some dimensions of spirituality and poor symptomatic control, resiliency, and social support. In the structural model, three variables predicted spirituality: having physical symptoms as the main source of discomfort, resiliency, and social support. This work highlights the relevance of the relationships among spirituality and other aspects of the patient at the end of life.
ABSTRACTObjective:This study aimed to develop a new and brief instrument to be employed in dignit... more ABSTRACTObjective:This study aimed to develop a new and brief instrument to be employed in dignity measurement, one based on the perceptions of patients, relatives, and professionals about dignity.Method:Surveys of patients receiving palliative care, family caregivers, and palliative care professionals were first carried out (sample 1). In the second step, palliative care patients were surveyed with a pilot questionnaire (sample 2). Finally, a survey design was used to assess patients admitted into a home care unit (sample 3). Sample 1 included 78 subjects, including patients, family caregivers, and professionals. Some 20 additional palliative patients participated in sample 2. Finally, 70 more patients admitted to a home care unit participated were surveyed (sample 3). Together with the Palliative Patients' Dignity Scale (PPDS), our survey included other measures of dignity, anxiety, depression, resilient coping, quality of life, spirituality, and social support.Results:After a...
This study evaluated the effectiveness of a psychological intervention in amyotrophic lateral scl... more This study evaluated the effectiveness of a psychological intervention in amyotrophic lateral sclerosis patients, consisting of four semi-structured sessions of cognitive behavioural therapy combined with counselling techniques. An intervention group and a control group were established. The Hospital Anxiety and Depression Scale was used to assess levels of anxiety and depression. In total, fifty-four patients took part. Prior to the intervention, the intervention group displayed rates of 63.3 and 36.7 per cent for anxiety and depression, respectively, falling to 16.7 and 10.0 per cent afterwards. The psychological intervention demonstrated potential for the reduction of levels of anxiety and depression in amyotrophic lateral sclerosis patients.
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