Binge eating disorder and stress level among patients attending nutrition counseling / Trastorno por atracón y nivel de estrés entre los pacientes que asisten a asesoramiento nutricional

Introduction: binge eating disorder (BED) is characterized by eating much more than what most people would eat under similar circumstances. Inability to cope with stress and emotions may be the reason for BED episodes. Objective: to assess the level of stress and BED severity based on the number of episodes of compulsive overeating among patients attending nutrition counseling. Methods: a total of 100 people (60 women and 40 men) were taking part in the study. A questionnaire in which subjects answered questions concerning diet, number of meals, and coping with stressful situations was used. A nutritional diary was used to assess the amount of BED episodes and consumed products, and the emotions felt during consumption. PSS-10 was used to measure the response to stressful situations. Results: all subjects had episodes of compulsive overeating but the majority of respondents (52 %) had no more than 3 episodes of binge eating per week. During a BED episode patients most often chose sweets (58.2 %). The main way of responding of people on stressful situations was snacking, especially sweets. Conclusions: high levels of stress correlated positively with the number of BED episodes and excessive body weight. The PSS-10 questionnaire could be a useful tool in nutrition counseling (AU)

Introducción: el trastorno por atracón (BED) se caracteriza por comer mucho más de lo que la mayoría de la gente comería en circunstancias similares. La incapacidad para lidiar con el estrés y las emociones puede ser la razón de los episodios de BED. Objetivo: evaluar el nivel de estrés y la gravedad del BED en función del número de episodios de sobrealimentación compulsiva entre los pacientes que acuden a asesoramiento nutricional. Métodos: en el estudio participaron 100 personas (60 mujeres y 40 hombres). Se utilizó un cuestionario en el que los sujetos respondieron a preguntas relativas a la dieta, la cantidad de comidas y el afrontamiento de las situaciones estresantes. Se utilizó un diario nutricional para evaluar la cantidad de episodios de BED, los productos consumidos y las emociones durante el consumo. Se utilizó el PSS-10 para medir la respuesta a las situaciones estresantes. Resultados: todas las personas tuvieron episodios de comer compulsivamente, pero la mayoría de los encuestados (52 %) no presentaron más de 3 episodios de atracones en la semana. Durante un episodio de BED, los pacientes eligieron con mayor frecuencia los dulces (58,2 %). La principal forma de respuesta de las personas ante situaciones estresantes era picar, especialmente dulces. Conclusiones: los altos niveles de estrés se correlacionaron positivamente con el número de episodios de BED y el peso corporal excesivo. El cuestionario PSS-10 podría ser una herramienta útil en un asesoramiento nutricional (AU)

Reducing Social Anxiety among Adolescents in the Covid-19 Era: Rational Emotive Behavior Therapy as a Counselling Approach

While the prioritization and rollout of vaccines against COVID-19 in most countries of the worldremains the only means to save the world from the novel coronavirus pandemic, which has continuedto disrupt the traditional way of life for everyone, the increased social anxiety that can help to reducevaccine hesitancy has been spared, especially in the developing nations. Therefore, this study aimedto adopt the Rational Emotive Behavior Therapy (REBT) counselling approach to manage socialanxiety among adolescents in the COVID-19 era. A quasi-experimental design (pre- post-test andcontrol group) was adopted. Using the multistage sampling technique, 88 adolescents were randomlyassigned to REBT (n= 43) and control groups n= 45). The results indicated that REBT significantlyreduced social anxiety with pre-test and post-test mean scores of 47.56 (47.56%) ± 6.58 and 30.23(30.23%) ±14.29, respectively. The main effect of REBT treatment was found to be significant (F2, 233= 41.82, p= .000). Conversely, the two-way interaction between treatment and gender was notstatistically significant. It was concluded that REBT is an effective counselling approach in reducingsocial anxiety among school-going adolescents, and that the treatment was not gender specific (AU)

Differences About Reasons and Sources of Information for Choosing Degree Courses / Diferencias en las Motivaciones y las Fuentes Consultadas Para Elegir Estudios Universitarios

Background:Only a few months before starting university, more than50% of Spanish high-school students do not know what course to choose.Data from the Ministry of Education show that dropout rates reach 40% insome Spanish communities. This study aims to analyse the most importantreasons behind students’ choices of degree course and the sources ofinformation they use to help them choose depending on the type of theschool and the field of study chosen. Method: A sample of 2,254 studentsfrom all over Spain completed two previously validated questionnaires.Results: The results showed that in general terms, intrinsic motives weremore highly valued. The sources of information that students used mostand rated more highly were university websites and family advice. Studentsfrom private schools rated guidance activities organized by universitiesmore highly than students from state schools. Mann-Whitney U andKruskal-Wallis statistics showed that the intrinsic component was morehighly valued by students who wanted to study degrees in the fields of Artsand Humanities or Services. Conclusions: These findings provide qualityinformation that may be used to improve the effectiveness of guidancecounselling activities.

Antecedentes: a pocos meses de realizar lamatrícula, más del 50% de los estudiantes españoles de Bachillerato no sabequé carrera elegir. Los datos del Ministerio de Educación muestran que lastasas de abandono llegan al 40% en algunas comunidades españolas. Esteestudio pretende analizar los motivos y fuentes más relevantes durante laelección de carrera universitaria según la titularidad del centro educativoy el campo de estudio elegido. Método: participaron un total de 2.254estudiantes de Bachillerato a los que se le aplicaron dos cuestionariospreviamente validados. Resultados:los resultados mostraron que lasmotivaciones de tipo intrínseco son las mejor valoradas. En cuanto a lasfuentes de información, las más utilizadas y valoradas son las páginas webde las universidades y el consejo de las familias, siendo las actividades deorientación de las universidades más valoradas por los estudiantes de la redprivada y concertada que por los de la pública. Los estadísticos U de Mann-Whitney y Kruskal-Wallis revelaron que existe una mayor relevancia dela componente intrínseca en los estudiantes que desean cursar grados deArtes y Humanidades o de Servicios. Conclusiones: estos hallazgosaportan información de calidad para mejorar la eficiencia de las actividadesorientación.

Counselling toward reducing alcohol use, knowledge about its morbidity and personal consumption among students of medical and dental courses in north-western Spain

Background: Alcohol use disorder (AUD) is directly linked to high-risk consumption. Healthcare students have a crucial role to play in its prevention and management. The aim of this study is to analyse alcohol consumption, as well as to consider the knowledge and attitudes regarding morbidity, and the stage of change when providing assistance to quit AUD. Material and Methods: A cross-sectional study was conducted among Dentistry and Medical students using specific and validated questionnaires in an anonymous and voluntary way. Initially, 925 students were invited to participate, of them 500 were reached. Results: Among them 85.9% suffered from AUD of whom 75% were women (p<0.001), and it was considered that the female gender constituted an independent risk factor (OR=2.63, CI 95% 1.55-4.45, p<0.001). The majority of the participants did not achieve the pass mark, nonetheless, the results showed improved levels of knowledge among participants in the latter years of their studies (p<0.001). Dental students demonstrated greater shortcomings in terms of their knowledge of general pathology, whereas the medical students’ knowledge of oral pathologies proved worse (p<0.001). Most of students believed that identifying cases of AUD-affected patients falls within their competence, nonetheless, they believed that they do not have the necessary competencies. Among participants 58.2% were in a stage of change regarding AUD attitudes. Conclusions: The majority of respondents presented AUD. In general, the participants’ knowledge about alcohol was low. Reviewing the syllabuses and evaluating the implementation of gender-differentiated training programmes in both degrees would be considered necessary.(AU)

Improving outpatient medication counselling in hospital pharmacy settings: a behavioral analysis using the theoretical domains framework and behavior change wheel

Background: Despite the importance of medication counselling for patients, it is common knowledge that it is often sub-optimally carried out by pharmacy staff. While some interventions have been designed to help improve counselling, no study till date has used the Capability Opportunity and Motivation behavior model (COM-B) or Theoretical Domains Framework (TDF) as a basis for identifying evidence-based intervention strategies to improve medication counselling. Objective: To understand barriers/facilitators to optimal medication counselling by conducting a behavioral analysis using the COM-B model and TDF, and use the Behavior Change Wheel (BCW) as a basis for identifying evidence-based intervention strategies and policy categories that could be used to improve outpatient medication counselling by pharmacy staff in hospital settings located within Northwest Nigeria. Methods: Semi-structured interviews were used to collect data from 25 purposively sampled pharmacy staff working at eight major public hospitals, from January till March 2020. Data from the interviews were then transcribed and deductively coded using the COM-B model and TDF. These findings were then used to identify areas requiring change, as well as the intervention type and policy functions required to support these changes. Results: Findings from the behavioral analysis revealed shortfalls in pharmacy staff capability, opportunity and motivation with respect to outpatient medication counselling. To improve their counselling behaviors, change was identified as necessary (AU)

Research orientations related to guidance and counselling programmes: A content analysis study / Orientaciones de investigación relacionadas con los programas de orientación y asesoramiento: un estudio de análisis de contenido

Guidance and psychological counselling services, which are seen as an integral part of the education system, refer to the whole of systematic services offered in line with a certain plan and programme. Guidance and counselling programmes (G&CP) are of considerable importance in the provision of these services based on data and evidence and in obtaining the expected efficiency from the services. The aim of this study is to evaluate the studies on G&CP in terms of content analysis, to reveal the current situation and to determine the scientific research orientations related to these studies. With this study, it was aimed that field staff, educators and researchers should recognise the gaps in the G&CP field, gain different perspectives on their fields of study and shed light on new research in this field. The data related to this study, which was designed according to the descriptive survey model using qualitative research methodology, were obtained by document review method. In connection with the topic of re-search, 105 graduate thesis studies in the ProQuest Dissertations and Theses database between 2007 and 2019 and 133 journal articles in the Web of Science database were examined. The obtained data were evaluated using the descriptive content analysis method. Studies on the subject have in-creased in recent years and more than half of the research has been carried out in the United States. It was observed that experimental studies were conducted using the most quantitative research methodology, that more emphasis was placed on the programme evaluation process and that sample groups at different levels, especially school counsellors, were studied. Additionally, there are some findings supporting that there are more studies concerning community-based preventive and intervention programmes than school-based studies, and also supporting the fact that school-related researches are especially paying attention to investigate the effects of the programme, perceptions and experiences of the programme, programme design and programme evaluation. Finally, the results from the research findings were interpreted and the recommendations for the researchers were presented

Los servicios de orientación y asesoramiento psicológico, que se consideran parte integrante del sistema educativo, se refieren al conjunto de servicios sistemáticos que se ofrecen de acuerdo con un determinado plan y programa. Los programas de orientación y asesoramiento (POA) son de considerable importancia en la prestación de estos servicios basados en datos y pruebas y en la obtención de la eficiencia esperada de los servicios. El objetivo de este estudio es evaluar los estudios sobre POA en términos de análisis de contenido, revelar la situación actual y determinar las orientaciones de investigación científica relacionadas con estos estudios. Con este estudio, se pretendía que el personal de campo, los educadores y los investigadores reconocieran los desajustes en el campo de POA, obtengan diferentes perspectivas sobre sus campos de estudio y arrojen luz sobre nuevas investigaciones en este campo. Los datos relacionados con este estudio, que fue diseñado según el modelo de encuesta descriptiva utilizando metodología de investigación cualitativa, se obtuvieron mediante el método de revisión de documentos. En relación con el tema de investigación, se examinaron 105 estudios de tesis de posgrado en la base de datos de tesis y disertaciones de ProQuest entre 2007 y 2019, y 133 artículos de revistas en la base de datos de Web of Science. Los datos obtenidos se evaluaron mediante el método de análisis de contenido descriptivo. Los estudios sobre el tema han aumentado en los últimos años y más de la mitad de las investigaciones se han realizado en Estados Unidos. Se observó que los estudios experimentales se realizaron utilizando la metodología de investigación más cuantitativa, que se puso más énfasis en el proceso de evaluación del programa y que se estudiaron grupos de muestra de diferentes niveles, especialmente orientadores escolares. Además, hay algunos hallazgos que respaldan que hay más estudios sobre programas de intervención y prevención basados en la comunidad que estudios basados en la escuela, y también respaldan el hecho de que las investigaciones relacionadas con la escuela están prestando especial atención a investigar los efectos, las percepciones y experiencias, el diseño y la evaluación del programa. Finalmente, se interpretaron los resultados de los hallazgos de la investigación y se presentaron las recomendaciones para los investigadores

Evaluation of simulated drug dispensing and patient counseling in the course of pharmaceutical improvement: 2009 to 2015

BACKGROUND: Aiming to facilitate the drug dispensing process and patient counseling, specific professional skills are required. The knowledge, skills and attitudes involved in this process can be improved. From 2012 to 2015, a nationwide course was held, in partnership with the Ministry of Health and the Federal University of Rio Grande do Sul (UFRGS) - Brazil, to train pharmacists working in primary health care through the development of their clinical and communication skills. One of the steps in this process involved the simulation of the drug dispensing process and patient counseling. OBJECTIVE: To evaluate the performance of pharmacists in drug dispensing and counseling through patient simulation role-playing held in a face-to-face meeting at the end of a training course. METHODS: A cross-sectional and retrospective study with analysis of patient simulation recordings and data collection using an assessment instrument with scores ranging from 0 to 10 points to assess pharmacist's behavior, skills, and technical knowledge. RESULTS: Participants presented poor-to-regular performance, with median scores equal to or lower than six. The median time of the drug dispensing simulation was five minutes and the patient counseling was eight minutes. Pharmacists had better scores in the simulation of asthma cases. In drug dispensing, 99.5% of pharmacists had difficulty checking the patient's time availability, 98.5% did not know how to use the devices, and 94.7% did not advise the patient on what to do if they forgot to take a dose. In patient counseling simulation, 1.18% of pharmacists remembered to advise on what do with medication leftovers, and 50.6% asked questions that induced the patient's responses. CONCLUSIONS: The low-to-regular performance showed that pharmacists had difficulties at improving their skills in the performance of complete and effective drug dispensing and patient counseling

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The effect of coaching and mentoring towards nurse's caring and patient satisfaction

OBJECTIVE: To determine the effect of coaching and mentoring on nurses caring behavior and to identify the relationship between the nurses caring behavior and patient satisfaction. METHOD: Pre-experiment with one group pre-posttest design. The populations were 89 nurses and 150 patients. The sampling technique used was purposive sampling. The number of nurse respondents was 56 people who get coaching and mentoring and there are 100 different patients who rate nurses caring behavior and the level of patient satisfaction; 50 patients gave an assessment before the intervention, and 50 patients post-intervention. The research instrument was questionnaires. Data analysis used the Paired t-test and Pearson Correlation Test. RESULTS: Nurse caring behavior increased 9.98 points post-intervention and there was a significant relationship between nurses caring behavior with patient satisfaction (p = 0.002). CONCLUSIONS: coaching and mentoring increase the nurses caring behavior, and there is a significant positive relationship between nurses caring behavior and patient satisfaction

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Histerectomía y educación para la salud. Perspectivas de las mujeres histerectomizadas, sus parejas y los profesionales que las atienden / Hysterectomy and health education. Perspectives of women, their partners and the professionals who care them

OBJETIVO: Identificar los principales elementos relacionados con la educación para la salud dirigida a las mujeres histerectomizadas, considerando la perspectiva de las mujeres, sus parejas y los profesionales de la salud que las atienden. METODOLOGÍA: Estudio cualitativo, descriptivo, narrativo de tipo historia de vida, realizado durante los meses de mayo a diciembre de 2010 en una muestra por conveniencia de 85 personas distribuidas en 3 grupos de estudio: 57 mujeres, 15 hombres y 13 profesionales que atienden a mujeres histerectomizadas de un hospital público de Santiago de Chile. El análisis de los datos se llevó a cabo mediante un análisis de contenidos descrito por Krippendorff. El estudio contó con la aprobación del Comité de Ética del Servicio de Salud Metropolitano Suroriente. RESULTADOS: Los principales temas identificados fueron los siguientes: característica de la educación, contenidos educativos, momento en que se debe proporcionar la educación, metodologías de educación y profesional a cargo de proporcionar educación a las mujeres histerectomizadas. CONCLUSIONES: La preocupación de las mujeres por las consecuencias que tiene la extirpación del útero es un aspecto compartido también por sus parejas. Una «buena educación» incluye información oportuna sobre lo que se espera al alta, los síntomas que pudieran aparecer, dónde y cuándo contactar con un profesional. Someterse a una histerectomía implica para la mujer una transición a una nueva etapa de su vida, por lo que es fundamental la educación relacionada con los cambios que ocurrirán posteriormente. Para las mujeres, el apoyo de sus parejas es esencial durante este proceso

OBJECTIVE: Identify the main elements to be considered in education for hysterectomized women, considering the perspective of women, their partners and the health care providers. METHODOLOGY: Qualitative descriptive narrative study of life history type performed in a convenience sample of 85 people divided into three study groups: women, men and professionals who attend hysterectomized women at public hospital in Santiago, Chile. Content analysis was performed according to Krippendorff. The Ethics Committee of the South-East Metropolitan Health Service approved the study. RESULTS: The main topics identified were characteristics of education, educational contents, when education were delivered, educational methodologies, and professionals in charge of providing education to hysterectomized women. CONCLUSIONS: Regarding the content considered relevant, the concern of women and their partners for the consequences of the removal of the uterus. An adequate education includes timely information regarding what is expected at discharge, symptoms that may appear, where and when to contact a professional. Being hysterectomized means for women a transition to a new stage of life, education in relation to the changes that will occur after HT is a fundamental part of the process. For women, the support of their partners is essential during this process

Examining the Factors Contributing to Adolescents' Online Game Addiction / Examen de los factores que contribuyen a la adicción al juego on line en adolescentes

In this study, it was aimed to examine the level of online game addiction among high school students in terms of basic psychological needs, sensation seeking and some variables. The study group of the study consisted of 214 high school students, 150 of whom were male and 64 female. Data from the study were collected using the Online Game Addiction Scale, the Basic Psychological Needs Scale, and the Sensation Seeking Scale. The dependent variable of the research is the online game addiction, while the independent variables are the search for excitement, basic psychological needs, gender, the type of online game the individual learns online and the type of online game played. Multiple regression analysis was used to determine whether the independent variables predicted the dependent variable. In addition, it was determined by independent sample t test whether the level of online gaming addiction differed according to sex, and at the same time whether the individual was different according to the type of online game or not was also examined by one way variance analysis. According to the result of correlation analysis, it has been found that there is a positive and significant relationship between online gaming addiction and the sensation seeking and basic psychological needs. Besides, it was also determined that the level of online game addiction differ statistically significantly depending on the variables such as gender, from whom the game was learned and the type of online game

En este estudio, el objetivo fue examinar el nivel de adicción a los juegos on line entre los estudiantes de secundaria en términos de necesidades psicológicas básicas y búsqueda de sensaciones. El grupo de estudio consistió en 214 estudiantes de secundaria, 150 de los cuales eran hombres y 64 mujeres. Los datos del estudio se recolectaron utilizando la Escala de Adicción a los Juegos en Línea, la Escala de Necesidades Psicológicas Básicas y la Escala de Búsqueda de Sensaciones. La variable dependiente de la investigación es la adicción a los juegos on line, mientras que las variables independientes son la búsqueda de emoción, las necesidades psicológicas básicas, el género, el tipo de juego on line que el individuo aprende y el tipo de juego on line. El análisis de regresión múltiple se utilizó para determinar si las variables independientes predijeron la variable dependiente. De acuerdo con el resultado del análisis de correlación, se ha encontrado que existe una relación positiva y significativa entre la adicción al juego on line y la búsqueda de sensaciones y las necesidades psicológicas básicas

Efectividad del consejo médico para dejar de fumar en pacientes con orbitopatía de Graves / Effectiveness of oral counselling for smoke cessation in Graves orbitopathy patients

Objetivo: El tabaco es un factor de riesgo en la orbitopatía de Graves (GO) y es modificable. El consejo médico para dejar de fumar se ha incluido en todas las guías de práctica clínica de esta enfermedad, aunque su efectividad no ha sido evaluada. El objetivo de este estudio es conocer el cambio producido en el hábito tabáquico en pacientes con GO tras una recomendación verbal para dejar de fumar. Material y métodos: Se estudió una cohorte retrospectiva de pacientes con GO. Todos los pacientes recibieron consejo médico sobre la importancia de dejar de fumar en la primera consulta del oftalmólogo. Entre 2013 y 2014 se atendió a 33 pacientes en la consulta, que fueron preguntados sobre el cambio en su hábito tabáquico en 2015. La variable principal de estudio fue el número de cigarros fumados al día antes y después de las consultas en endocrinología y oftalmología. Aparte, se recogieron otros datos personales médicos y socioeconómicos. Resultados: El número medio de cigarros fumados fue de 13,6 (DE 9,66) y 6,3 (DE 7,73) antes y después de la primera consulta en oftalmología, respectivamente (test t pareado, p < 0,05). El 42,42% de los pacientes dejó de fumar y el 30,3% disminuyó el consumo de cigarrillos. Los pacientes que consiguieron dejar de fumar presentaban con mayor frecuencia formas de enfermedad de Graves activas y graves, tenían trabajos estables y estaban apoyados por sus familiares y amigos. Conclusión: Un consejo fuerte y firme recomendando dejar de fumar es efectivo en pacientes con GO. Esta enfermedad afecta seriamente la calidad de vida de los pacientes, lo que hace que sean más susceptibles de cambiar a la hora de modificar sus hábitos

Objective: Smoking is an important risk factor for Graves orbitopathy (GO) and it is modifiable. The advice to stop smoking has been included in all the clinical practice guidelines of GO. However, the effectiveness of this practice remains unknown. The purpose of this study is to assess the change in the smoking habit in patients affected with GO after an oral counselling for smoking cessation. Material and methods: A retrospective cohort of GO patients was studied. The patients received a significant oral counsel during the first consultation with the ophthalmologist. 33 GO patients were explored in the ophthalmology clinic during 2013 and 2014 and the study was done throughout a telephone questionnaire in 2015. The main outcome was the number of cigarettes smoked daily before and after consultation with the endocrinologist and the ophthalmologist. Other medical and socioeconomic factors were recorded. Results: The mean number of cigarettes that were smoked was 13.6 (SD 9.66) and 6.3 (SD 7.73) before and after the consultation done at the ophthalmology office (T-test paired, P = 0.0006). 42.42% achieved smoking cessation and 30.3% decreased their smoking habit. Patients who stopped smoking suffered usually from active and severe GO, had more stable jobs and received greater support from their relatives and friends. Conclusion: A firm and strong oral counsel held for smoke cessation was effective in GO patients. This disease deeply affects patients’ quality of life, making them more prone to change their habits

Preparando el escenario para dejar de fumar en el paciente con Trastorno Bipolar: intervención breve en la práctica clínica / Setting the stage to quit smoking in Bipolar Disorder patients: brief advice in clinical practice

El consumo de tabaco es el principal factor prevenible de mortalidad en pacientes con trastorno bipolar (TB), y las posibles soluciones se encuentran bloqueadas por prejuicios acerca del deseo, posibilidades y riesgos al dejar el consumo de tabaco en estos pacientes. En 8 Centros de Salud Mental se reclutaron consecutivamente pacientes con TB. Los fumadores fueron evaluados antes y después de una intervención breve basada en las 3 As y clasificados según los "estadios de cambio" (EC) y su "disposición para el cambio" (DC). Mediante una regresión lineal múltiple se analizó la evolución del DC y su efecto sobre otras variables independientes (tratamiento farmacológico, historias de síntomas psicóticos, presencia de síntomas de ansiedad, deseo de abandono, capacidad auto-percibida y la percepción subjetiva de funcionamiento cognitivo). Se incluyeron 212 pacientes con TB estabilizados, los fumadores activos (n = 101; 47.6%) pasaron a la fase de intervención, y un 80.2% la completaron. Basalmente, 75.2% consideraban la idea de dejar de fumar, después de la intervención breve, el 30.9% de los pacientes progresó en su EC. Se observó un incremento significativo del nivel de DC (53.3 vs 59.3, P = 0.019). La autopercepción del rendimiento cognitivo (β = -0.35;P = 0.002), el deseo de abandono (β = 0.32;P = 0.008), la autopercepción de la capacidad para dejar de fumar (β = -0.30;P = 0.012), la edad del paciente (β = -0.72;P = 0.004), la edad de inicio del tabaquismo (β = 0.48;P = 0.022) y los años fumando (β = 0.48;P = 0.025) fueron los factores que influyeron significativamente en la posibilidad de cambio tras la intervención breve. Los fumadores con TB consideran la idea de dejar de fumar y una intervención breve desarrollada en el marco de la atención a la salud mental diaria, mejoraría el nivel de preparación. La disfunción neurocognitiva asociada con el TB podría limitar la disposición de los pacientes a dejar de fumar

Tobacco consumption is the main preventable factor of mortality in smokers with bipolar disorder (BD), and any possible solutions are often blocked by prejudices over desire, and the possibilities and risks for these patients in giving up tobacco consumption. Adults with BD were recruited at 8 Mental Health Centres. Smokers were evaluated before and after a brief intervention based on the 3 A's and classified into a 'Stage of Change' (SOC) and their 'Readiness to Change' (RTC). A multiple linear regression was used to analyze the progression in their RTC and the independent effect of different variables (pharmacological treatment, history of psychotic symptoms, current anxiety symptoms, willingness, self-perceived capacity to quit smoking and subjective perception of cognitive functioning). Of 212 stable patients diagnosed with BD, current smokers (n = 101; 47.6%) were included in the intervention phase, and 80.2% completed it. At baseline, 75.2% were considering the idea of giving up smoking and, after the brief intervention, 30.9% of the patients progressed in their SOC. A significant increase in the level of RTC was observed (53.3 vs 59.3, P = 0.019). Perception of cognitive performance (β = - 0.35;P = 0.002), the degree of willing to quit (β = 0.32;P = 0.008), selfperceived capacity to quit tobacco smoking (β = -0.30; P = 0.012), the patient's age (β = -0.72; P= 0.004), the age of onset of smoking (β = 0.48;P = 0.022) and years as a smoker (β = 0.48;P = 0.025) were all factors that significantly influenced the chances of improving after the short intervention. Smokers with BD consider the idea of quitting and a brief intervention developed in the every day mental health care setting improves the level of readiness. The neurocognitive dysfunction associated with BD may limit patients' readiness to quit smoking

Abordaje integral del paciente desnutrido: buscando la continuidad en el apoyo nutricional / Comprehensive approach for malnourished patients: aiming for continuity in nutritional support

La principal causa de desnutrición en nuestro entorno es la enfermedad. Esta circunstancia lleva asociada un aumento en los costes derivado del aumento de los días de hospitalización, que conlleva un mayor número de pruebas complementarias y el incremento del soporte nutricional artificial y/o de medicamentos para tratar las complicaciones, lo que supone una carga económica muy importante. La mayoría de los pacientes malnutridos o en riesgo de estarlo pueden beneficiarse de apoyo nutricional por vía oral, lo que incluye modificaciones de la dieta (fortificación, snacks extras, etc.), prescripción de una dieta personalizada por una dietista y el uso eventual de suplementos nutricionales orales (SNO). Diversos metaanálisis han demostrado beneficios en el uso de SNO en la recuperación ponderal, en la disminución del número de complicaciones y de reingresos y en una mejoría funcional sin que se produzca una reducción de la ingesta habitual de alimentos. El uso de SNO es particularmente coste-efectivo en determinados subgrupos de edad (ancianos con fragilidad), estado nutricional (desnutrición previa) y enfermedad subyacente (fractura de cadera, cirugía abdominal, etc.). Por otra parte, un paciente que transita entre diferentes entornos sanitarios (centro de salud, residencia sociosanitaria, hospital de agudos) presenta dificultades añadidas para evaluar el efecto del apoyo nutricional, ya que el gasto que realizamos en un entorno repercute con frecuencia en otro (por ejemplo, en los reingresos hospitalarios). Esta circunstancia dificulta el control por parte de los agentes reguladores de la prescripción y genera el debate sobre la continuidad de los tratamientos en los diferentes escenarios. La repercusión de un episodio de hospitalización en el estado funcional a treinta días del alta ("síndrome posthospitalización") constituye un periodo transitorio de especial vulnerabilidad en episodios de comorbilidad y de riesgo de reingreso. El apoyo nutricional (consejo dietético más uso de SNO) genera ahorros de alrededor del 5% del gasto sanitario en los grupos de intervención en comparación con la práctica habitual, junto con una disminución significativa del número de reingresos hospitalarios. El apoyo nutricional a lo largo de los distintos escenarios en los que se encuentre el paciente ha demostrado ser coste-efectivo, ya que no supone costes extras por unidad de mejora, tanto clínica como funcional, por lo que puede ser defendido desde el punto de vista del gasto sanitario. Estos resultados subrayan la necesidad de prestar atención a la detección del riesgo de desnutrición y a su tratamiento como parte del cuidado médico estándar en el proceso de transición entre el hospital y el domicilio del paciente. Es responsabilidad de los gestores asegurar que en sus centros se realice de forma rutinaria la detección y el tratamiento de la malnutrición, tanto en el ámbito hospitalario como en residencias sociosanitarias y en el domicilio, así como integrar la nutrición clínica entre los cuidados médicos estandarizados de cualquier paciente, lo que plantea la importancia de incluir conocimientos en esta materia en los planes formativos del personal sanitario

Disease is the main cause of malnutrition in our health and social care settings, and it is associated with an increase in costs, as a result of more days of hospitalization, a greater number of complementary tests, the need for artificial nutritional support and / or drugs to treat complications, which is a very important economic burden. Most patients who are malnourished, or at risk, can benefit from oral nutritional support, which includes dietary modifications (fortification, extra snacks, etc.), prescription of a personalized diet by a registered dietitian and the use of oral nutritional supplements (ONS). The use of ONS has shown benefits, in several meta-analysis, in weight recovery, reduction in the number of complications or hospital readmissions and functional improvement, without a reduction in the usual food intake. The use of ONS is particularly cost-effective in certain subgroups of age (frail elderly), nutritional status (previous malnutrition) and underlying disease (hip fracture, abdominal surgery, etc.). On the other hand, there are additional difficulties to evaluate the effect of nutritional support in different healthcare settings (community, nursing home, hospital) since the economic burden in one environment often has an impact on another (for example: hospital readmissions). This circumstance makes it difficult for regulators to control the prescription and generates debate about the continuity of treatments in different settings. The repercussion of an episode of hospitalization on functional status, 30 days after discharge ("post hospital syndrome"), constitutes a transitory period of special vulnerability for comorbidity and hospital readmission risk. The nutritional support (dietary counselling + use of ONS) generates savings of around 5% of the health cost in the intervention group vs "usual practice", together with a significant decrease in the number of hospital readmissions. The nutritional support throughout the different scenarios where the patient is found has proven to be cost-effective, does not involve extra costs per unit of improvement, both clinical and functional, and can be defended from a health economic perspective. These results highlight the need to pay attention to the detection of malnutrition and its treatment as part of standard medical care in the transition process between the hospital and the patient's home. It is the responsibility of the health managers to ensure that the detection and treatment of malnutrition is routinely carried out in their centers, as well as integrating clinical nutrition into standardized medical care. of any patient, which raises the importance of including clinical nutrition in the training plans of the health personnel

Restoration-focused coping reduces complicated grief among older adults: A randomized controlled study

Background and objectives: The death of a loved one leaves a sizable minority of bereaved individuals at increased risk for complicated grief (CG), which can lead to adverse health outcomes. There has been increased interest in developing intervention options for CG based on the dual-process model of coping with bereavement, which addresses both loss- and restoration-focused coping methods. Many loss-focused approaches have been employed in clinical settings, but the development of restoration-focused intervention method has received insufficient attention. Methods: This study examines the effectiveness of a restoration-focused intervention method called self-care in bereavement (SCB) and the mediating effects of changes in self-efficacy and personal growth on the relationship between the intervention method and CG. A total of 168 Korean older adults experiencing bereavement from the loss of a loved one were randomly assigned to the SCB group or the comparison group, which received only psychoeducation on CG. Results: The SCB group demonstrated a significant reduction in CG in comparison to the comparison group. Changes in self-efficacy and a sense of personal growth had significant mediating effects on the relationship between the intervention method and CG. Conclusion: These results suggest that SCB is a promising intervention method for CG and that the intervention effect may be mediated by positive changes in self-efficacy and a sense of personal growth

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Estudio comparativo de la eficacia del counselling y de la terapia de la dignidad en pacientes paliativos / Comparative study on the efficacy of Counselling and Dignity Therapy in palliative care patients

OBJETIVO: Existen múltiples trabajos que contemplan el conjunto de las necesidades de los pacientes al final de la vida, contando con propuestas de modelos integrales para una intervención terapéutica paliativa. La metodología más común que aborda estas necesidades es la intervención de counselling, aunque recientemente también ha crecido el uso internacional de la «terapia de la dignidad». Este estudio tiene como objetivo identificar y cuantificar diferencias en términos de distrés emocional, calidad de vida y preservación de la dignidad tras el tratamiento con estos 2 tipos de INTERVENCIONES: MÉTODO: Diseño cuasi-experimental en la Unidad de Hospitalización a Domicilio (UHD) del Hospital General Universitario de Valencia. Tras aplicar criterios de inclusión y exclusión, 30 pacientes con diagnóstico oncológico avanzado fueron asignados aleatoriamente a los 2 grupos de intervención. Se registraron datos sociodemográficos, clínicos, sobre malestar emocional (EVA sufrimiento), ansiedad (HADS), depresión (HADS), dignidad (IPD) y calidad de vida (EORT-QLQ-30). Siguiéndose las guías de intervención, los pacientes recibieron tratamiento psicológico de 2-3 sesiones semanales en sus domicilios. Se llevaron a cabo pruebas t y χ2para comparar las características de los grupos en la línea base, pruebas t de medidas repetidas para evaluar la eficacia de los tratamientos y pruebas t para muestras independientes para comparar las diferencias entre INTERVENCIONES: RESULTADOS: Los grupos no fueron diferentes en la línea base en ninguna de las variables, a excepción del género. El grupo counselling mejoró las variables sufrimiento, calidad de vida y 2 de las dimensiones de dignidad (angustia existencial y angustia dependencia). El grupo Dignidad obtuvo los mismos resultados, a excepción de la variable ansiedad, en la que no se encontró mejoría tras la intervención. La comparación de la eficacia de las intervenciones no mostró diferencias entre estas. CONCLUSIONES: Ambas intervenciones fueron beneficiosas para los pacientes, en la misma medida, mejorando su calidad de vida, bienestar emocional y distrés. Futuras investigaciones deberían abordar esta problemática haciendo frente a una de las limitaciones del estudio, el reducido tamaño muestral, y estudiar la posible replicabilidad de los resultados encontrados en este trabajo, pionero en terapia de la dignidad en el contexto español

AIM: Many works contemplate patient needs at the end of life, with many integral models for palliative care INTERVENTIONS: The most commonly used methodology for meeting these needs is Counselling therapy, although recently there has been an increase in the international use of the Dignity therapy. This study aims to identify and quantify differences in emotional distress, quality of life, and preservation of dignity after both of these types of INTERVENTIONS: Method: A study of quasi-experimental design was developed in the Home Hospitalization Service (HHS) of University General Hospital of Valencia. After applying inclusion and exclusion criteria, 30 patients with an advanced oncology diagnosis were randomly assigned to the two intervention groups. Data were collected on sociodemographic, clinical, emotional distress (EVA), anxiety (HADS), depression (HADS), dignity (PDI) and quality of life (EORT-QLQ-30). Following intervention guides, patients received psychological treatment of 2-3 sessions per week at home. The statistics tests t and χ2 were used to compare the baseline characteristics of both groups, t tests for repeated measures to assess treatments efficacy, and t tests for independent groups to compare differences between INTERVENTIONS: RESULTS: There were no differences between the groups at baseline, except for gender. The Counselling group improved in suffering, quality of life, and in two of the dignity dimensions (existential and dependence anguish). The Dignity group results were similar, except for anxiety, which did not improve after the intervention. The comparison of efficacy showed no differences between the INTERVENTIONS: CONCLUSIONS: Both interventions were beneficial for patients, to the same extent, improving their quality of life, emotional well-being, and distress. Future research should study this situation taking into account one of the limitations of this study, the small sample size, and studying the repeatability of the results found in this ground-breaking work on Dignity Therapy in the Spanish context

Percepción de embarazadas y matronas acerca de los consejos nutricionales durante la gestación / Pregnant’s and midwives perception about nutrional councils during pregnancy

Introducción: el estado nutricional previo de la embarazada, la adecuada ganancia de peso y la ingesta de ciertos nutrientes pueden tener una influencia importante tanto para la madre como para el recién nacido, a corto y largo plazo. Las recomendaciones de la Organización Mundial de la Salud son transmitidas durante el control del embarazo por la matrona. Objetivos: analizar los principales estudios sobre la percepción de las embarazadas acerca de los consejos nutricionales recibidos e identificar las estrategias utilizadas por las matronas para su implementación. Metodología: búsqueda bibliográfica sobre embarazadas de bajo riesgo controladas por matronas y que reciben consejos nutricionales realizada en WOS, CINHAL y PubMed. Se utilizaron los descriptores: pregnancy, pregnant, midwife, counselling, nutrition y sus diferentes combinaciones. Los criterios de inclusión fueron artículos originales y revisiones en inglés, español o portugués de los últimos diez años y disponibles en texto completo. Resultados: se encontraron 184 referencias. Solo 11 tratan el tema abordado. Existen múltiples artículos con consejos nutricionales en el embarazo, pero muy pocos que incluyan estrategias educativas implementadas por las matronas que aborden recomendaciones dietéticonutricionales y su utilidad. Conclusión: existen escasos estudios que investiguen los conocimientos que las matronas tienen sobre nutrición en el embarazo y los consejos que aportan sobre el tema. Igualmente sucede con los trabajos que estudian la percepción que tienen las gestantes sobre los consejos nutricionales recibidos (AU)

Background: Women’s nutritional status, the suitable profit of weight and the ingestion of certain nutrients may have an important influence in health both for the mother and newborn in a short and long term. World Health Organization gives a number of nutritional recommendations which are transmitted during the pregnant women antenatal care by their midwives. Objectives: To analyze the main studies on the understanding of the pregnant women about the nutritional received councils and to identify the strategies used by the midwives for theirs implementation. Methodology: Literature review for low risk pregnant’s conducted by midwives and receiving nutritional councils in Web of Science (WOS), CINAHL and PubMed. Using descriptors such as: pregnancy, pregnant, midwife, counselling, nutrition and their different combinations. The criteria incorporation was original article and review written in English, Spanish or Portuguese of last ten years and available in complete. Results: 184 references were found. Finally, only 11 focused on the issue addressed. There are multiple items with nutritional advice in pregnancy but a few that include educational strategies implemented by midwives to address dietary and nutritional recommendations and usefulness. Conclusion: Only a few studies researchs the midwives’ knowledge about nutrition in pregnancy and the councils that they transmit to pregnants. In the same way, not many papers treats the pregnant perception about nutritional councils (AU)

Prevalencia y factores asociados a la práctica del consejo clínico contra el consumo de drogas entre los especialistas internos residentes de Andalucía (España) / Prevalence and factors associated with clinical counselling on drug use among internal specialists residents of Andalusia (Spain)

OBJETIVOS: Conocer la frecuencia de la oferta de consejo clínico contra el consumo de alcohol, tabaco y drogas ilegales por los especialistas internos residentes (EIR) y los factores relacionados con dicho consejo. DISEÑO: Estudio multicéntrico transversal mediante encuesta autoadministrada. EMPLAZAMIENTO Y PARTICIPANTES: EIR de Andalucía (España), mediante correo electrónico. MEDICIONES PRINCIPALES: Consejo declarado contra alcohol, tabaco y drogas ilegales, mediante escala Likert categorizada como ®frecuente»/®no frecuente». Variables independientes: edad/sexo, especialidad, país de origen y características del consumo de drogas. Análisis mediante regresión logística. RESULTADOS: Cuatro mil doscientos cuarenta y cinco participantes con el 66% de respuestas, 29% no respondedores y 5% mala cumplimentación; edad media 29,1 ± DE 5,1 años, 69% mujeres, 89% nacionalidad española, 84% con formación en medicina (hospitalaria 73%, medicina familiar 27%). El consejo frecuente contra tabaco (85%) y alcohol (82%) es superior al de drogas ilegales (56%; p < 0,001 test de Chi cuadrado). El consejo frecuente contra el alcohol se relaciona con la especialidad (medicina familiar: OR = 2,8, IC 95% [1,4-4,6]; enfermería: OR = 2,5 [1,7-4,4]) y la edad del primer consumo alcohólico (OR = 1,07; [1,03-1,1]). Para el tabaco hay relación con la especialidad (medicina familiar: OR = 12,9 [7,6-21,9]; enfermería: OR = 8,4, [4,3-16,5]), el tabaquismo (OR = 1,5 [1,2-2,0]) y edad del primer consumo alcohólico (OR = 1,06 [1,01-1,1]), más importante para el vino (OR = 1,1 [1,04-1,3]). Aconsejar contra drogas ilegales se relaciona con la edad del primer consumo alcohólico (OR = 1,09 [1,05-1,1]) y el tabaquismo (OR = 0,58 [0,4-0,7]). CONCLUSIÓN: Hay una alta oferta de consejo contra el consumo por los EIR, aunque llamativamente menor para drogas ilegales. Los factores que influyen son tanto elementos formativos de su propia especialidad como el consumo personal de alcohol y tabaco, que deben ser tenidos en cuenta para una mejora de esta actividad preventiva

OBJECTIVES: To determine the percentage of women who have had a Pap smear in the last 5 years, and the place where it was carried out. To detect cytological abnormalities and precursors of cervical cancer in un-screened or inadequately screened women and the prevalence of HPV-positive determinations. DESIGN: Cross sectional study. SETTING: Natahoyo Health Centre, Gijón (Spain). PARTICIPANTS: Women aged 40-50 years living in the area and assigned to the Health Centre. METHODS: The information was collected from databases, telephone and home surveys. There was active recruitment of unscreened women or inadequately screened in Primary Care as well as offering to perform cytology and HPV determination. RESULTS: Of the 1420 women aged 40 to 50 years, 1236 (87%) had cytology in the last 5 years, and 184 women (13%) had no screening or it was inadequate. Of these 184 women, 108 (58.7%) agreed to have cytology and HPV test performed. No high-grade cervical dysplasia was diagnosed. The prevalence of HPV-positive was 8.3%. CONCLUSIONS: In our population there is a high coverage of opportunistic screening for cervical cancer. The active recruitment of women who were not in the screening program was not useful

Consejo nutricional: herramienta efectiva en la lucha contra la desnutrición / Nutritional counseling: an effective tool in the fight against malnutrition

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La Autoayuda y el consejo como procedimientos psicoterapéuticos / help and counsel as psychotherapeutic procedures

Autoayuda y consejo son actividadesdiferentes aunque pueden solaparse en algunos aspectos.El sentido de la autoayuda promueve frecuentementeuna concepción individualista de unsujeto desvinculado de su contexto y una visión delfuncionamiento psicológico en términos de parámetrosy entidades. Esta configuración de la persona altiempo promueve y es promovida por la cultura dela autoayuda y la práctica del consejo. Este es unode los marcos en los que se configuran los sujetos ylos problemas psicológicos materia de estudio y trabajode la psicología y la psicoterapia. Se proponencomo alternativas de interés en psicología y psicoterapialos conceptos de génesis y proceso, tanto anivel individual como colectivo (AU)

Self-Help and Counsel are differentactivities though can overlap each other in some aspects.The meaning of self help frecuently promotesan individualist conception of a subject which is dissociatedfrom his context, and a perspective of thepsychological functioning in terms of parameters andentities. This conception of the person at the sametime promotes and is promoted by the self-help cultureand counsel procedures. This culture is one ofthe frames that shape the subjects and psychologicalproblems that became object of study and work forpsychology and psychotherapy. Genesis and processare proposed as worth considering alternative conceptsfor psychology and psychotherapy, both at anindividual and at a colective level (AU)

High trait anger Mexican youth: characteristics, parental anger and counseling needs

This study compared three groups of Mexican youth: (1) high trait anger adolescents recognizing anger problems (HR); (2) high trait anger youth not reporting anger problems (HNR); and (3) low trait anger adolescents not reporting anger problems (LNR). The HR group was sizable, representing 21% of all students and 72% of high anger youth. Compared to LNR, high anger groups (HR and HNR) experienced more angry feelings, engaged in anger suppression (e.g., holding anger in and harboring grudges) and aggressive anger expression (e.g., urges to aggression, physical aggressive anger expression toward others and toward self and objects), and reported lower internal and external anger control (e.g., relaxing and controlling one’s behavior when angry). High anger groups also reported greater trait anger in both parents than LNR, suggesting parent’s anger is a risk factor for anger in adolescents. HR and HNR groups, however, did not differ on any variable. Findings for high anger groups supported the intensity, aggression, and reduced positive coping hypotheses of State-Trait Anger Theory. Findings were also discussed in terms of the counseling needs of high anger Mexican youth and State-Trait Theory (AU)

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