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1.
Conserv Biol ; : e14253, 2024 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-38516741

RESUMO

Because global anthropogenic activities cause vast biodiversity loss, human dimensions research is essential to forming management plans applicable to biodiversity conservation outside wilderness areas. Engaging public participation is crucial in this context to achieve social and environmental benefits. However, knowledge gaps remain in understanding how a balance between conservation and public demands can be reached and how complicated sociocultural contexts in the Anthropocene can be incorporated in conservation planning. We examined China's nationwide conflict between free-ranging cats (owned cats that are allowed to go outdoors or homeless cats living outdoors) and wildlife to examine how a consensus between compassion and biodiversity conservation can help in decision-making. We surveyed a random sample of people in China online. Over 9000 questionnaires were completed (44.2% response). In aggregate, respondents reported approximately 29 million free-ranging owned cats and that over 5 million domestic cats per year become feral in mainland China. Respondents who were cat owners, female, and religious were more likely to deny the negative impacts of cats on wildlife and ongoing management strategies and more supportive of stray cat shelters, adoption, and community-based fund raising than nonowners, male, and nonreligious respondents (p < 0.05). Free-ranging cat ownership and abandonment occurred less with owners with more knowledge of biodiversity and invasive species than with respondents with less knowledge of these subjects (p < 0.05). We recommend that cat enthusiasts and wildlife conservationists participate in community-based initiatives, such as campaigns to keep cats indoors. Our study provides a substantially useful framework for other regions where free-ranging cats are undergoing rapid expansion.


Retos y oportunidades de las dimensiones humanas detrás del conflicto entre gatos y fauna Resumen Debido a que las actividades antropogénicas globales causan una enorme pérdida de la biodiversidad, la investigación sobre las dimensiones humanas es esencial para generar planes de manejo aplicables a la conservación de la biodiversidad fuera de las áreas silvestres. Es muy importante lograr que el público participe en este contexto para obtener los beneficios sociales y ambientales. Sin embargo, todavía existen vacíos en el conocimiento sobre cómo lograr el balance entre la conservación y las demandas públicas y cómo incorporar los contextos socioculturales complejos del Antropoceno a la planeación de la conservación. Analizamos el conflicto nacional entre los gatos libres (gatos callejeros o gatos domésticos que se les permite salir) y la fauna en China para estudiar cómo un consenso entre la compasión y la conservación de la biodiversidad puede ayudar en la toma de decisiones. Encuestamos en línea a una muestra aleatoria de personas en China. Se completaron más de 9000 cuestionarios (44.2% de respuesta). En total, los respondientes reportaron un aproximado de 29 millones de gatos libres y que más de cinco millones de gatos domésticos se vuelven ferales al año en China. Quienes respondieron y son dueños de gatos, mujeres y religiosos tuvieron la mayor probabilidad de negar los impactos negativos de los gatos sobre la fauna y de las estrategias actuales de manejo y de mostrar más apoyo por los refugios de gatos abandonados, la adopción y de la recaudación de fondos comunitaria que quienes no son dueños, no son religiosos y son hombres (p < 0.05). La propiedad de gatos libres y el abandono ocurrieron menos con los dueños con más conocimiento sobre la biodiversidad y las especies invasoras que con los respondientes con menos conocimiento sobre estos temas (p < 0.05). Recomendamos que los aficionados a los gatos y los conservacionistas de la fauna participen en las iniciativas comunitarias; por ejemplo, campañas para mantener a los gatos dentro de casa. Nuestro estudio proporciona un marco sustancialmente útil para otras regiones en donde los gatos libres se encuentran en rápida expansión.

2.
Gastroenterol Hepatol ; 47(1): 1-13, 2024 Jan.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-36841528

RESUMO

INTRODUCTION: The Colonoscopy Satisfaction and Safety Questionnaire based on Patient experience (CSSQP) was recently developed and validated within a Bowel Cancer Screening Program. We aimed to identify factor related to patient experience through the CSSQP, including all indications for colonoscopy. Indicators of satisfaction and perceived safety with colonoscopy were also assessed to compare the different centers. METHODS: Multicenter study in nine Spanish hospitals. Consecutive patients who had undergone a colonoscopy completed the CSSQP adding a novel item on bowel preparation. Factors related to patient experiences and data from non-respondents were analyzed. RESULTS: Of 2200 patients, 1753 filled out the questionnaire (response rate 79.7%, sample error 2%). Patients whose colonoscopy indication was a primary colorectal cancer screening (OR: 1.68, 95% CI: 1.15-2.44, p=0.007) or due to a +FIT (OR: 1.73, 95% CI: 1.18-2.53) reported higher satisfaction than patients with gastrointestinal symptoms. In addition, college-educated patients (OR: 2.11, 95% CI: 1.25-3.56) were more likely to report better overall satisfaction than patients with lower education level. Significant differences were observed in the majority of the CSSQP items between centers. Safety incidents were reported by 35 (2%) patients, and 176 (10%) patients reported that they received insufficient information. CONCLUSION: The CSSQP identifies several significant factors on satisfaction and perceived safety in patients referred for colonoscopy for any reason. The CSSQP also allows comparison of patient-identified colonoscopy quality indicators between centers.


Assuntos
Neoplasias Colorretais , Satisfação do Paciente , Humanos , Colonoscopia/efeitos adversos , Neoplasias Colorretais/diagnóstico , Inquéritos e Questionários , Avaliação de Resultados da Assistência ao Paciente
3.
Infant Ment Health J ; 2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-38992864

RESUMO

An efficient, multidimensional instrument is needed to screen non-optimal prenatal parental representations predictive of postnatal parenting behavior and child attachment. The present work aimed to revise and validate the Prenatal Caregiving Expectations Questionnaire-Revised (PCEQ-R). Survey data from two independent samples of pregnant, primarily Danish, women (N = 300/322) were collected to 1) test the factor structure and select items for a 20-item version, and 2) confirm the factor structure, examine internal consistency, and establish initial construct validity. Confirmatory factor analysis supported a three-factor model of helpless-dysregulated, anxious-hyperactivated, and avoidant-deactivated caregiving representations. Internal consistency was acceptable (α > .73). Construct validity analyses showed that higher helpless-dysregulated caregiving was associated with low maternal antenatal attachment quality (rs = -.36) and intensity (rs = -.11), increased risk of perinatal depression (rs = .37), and trait anxiety (rs = .37). Higher anxious-hyperactivated caregiving was associated with better maternal antenatal attachment quality (rs = .20) and higher intensity (rs = .26), while avoidant-deactivated caregiving was not associated with maternal antenatal attachment. These findings support the validity and multidimensional structure of the measure. The homogenous nature of the sample limits generalizability of results. Future studies should examine predictive validity of the PCEQ-R and include clinical samples.


Se necesita un instrumento eficiente y multidimensional para examinar las representaciones prenatales no óptimas de los progenitores que predicen la conducta de crianza y la afectividad del niño. El presente trabajo se propuso revisar y validar el Cuestionario de Expectativas Prenatales de Prestación de Cuidado­Revisado (PCEQ­R). Se recogió información de encuesta de dos grupos muestra independientes de mujeres embarazadas, primariamente danesas, para 1) probar la estructura de factores y seleccionar los puntos para una versión de 20 asuntos, y 2) confirmar la estructura de factores examinar la consistencia interna, así como establecer la validez del modelo inicial. Los análisis de factores confirmatorios apoyaron un modelo de tres factores de representaciones de prestación de cuidado: indefensas­desreguladas, ansiosas­hiperactivas y evasivas­desactivadas. La consistencia interna fue aceptable (α > .73). Los análisis de validez del modelo mostraron que una prestación de cuidado indefensa­desregulada más alta se asociaba con la baja calidad de la afectividad materna antenatal (rs = ­.36) y su intensidad (rs = ­.11), el aumento en el riesgo de depresión perinatal (rs = .37) y en el rasgo de ansiedad (rs = .37). Una más alta prestación de cuidado de tipo ansiosa­hiperactiva se asoció con una mejor calidad de la afectividad materna antenatal (rs = .20) y mayor intensidad (rs = .26), mientras que la prestación de cuidado evasiva­desactivada no se asoció con la afectividad materna antenatal. Estos resultados apoyan la validez y estructura multidimensional de la medida. La naturaleza homogénea del grupo muestra limita la posibilidad de generalización de los resultados. Estudios futuros deben examinar la validez de predicción de PCEQ­R e incluir grupos muestra clínicos.

4.
Aten Primaria ; 56(2): 102792, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37924620

RESUMO

OBJECTIVE: To validate a questionnaire to analyze the perception of users of primary care (PC) with telephone consultation (TC), and to study the satisfaction with TC by users of PC services. DESIGN: A two-phase study was conducted. Firstly, a questionnaire on satisfaction with telemedicine services was validated. Secondly, a cross-sectional study on satisfaction with TC was conducted. SETTING: PC. PARTICIPANTS: 405 users of PC services in Zaragoza (Spain). MAIN OUTCOME MEASURE: Our main outcome was the satisfaction with telemedicine services PC services. Factor analysis was carried out using the exploratory factor analysis with Varimax rotation. The reliability of the dimensions obtained was analyzed using Cronbach's alpha. The inferential analysis was conducted using parametric tests. RESULTS: The questionnaire was a valid and reliable tool (α>0.9) to assess the satisfaction of PC service users with telemedicine services. Before COVID-19, the satisfaction of the users with PC was adequate (mean=6111/10). However, during the COVID-19 the attention in PC centers became mostly telephone-based and satisfaction lowered as disappointing (mean=3555/10). Regarding the future of telemedicine, users considered it as unsatisfactory (mean=2977/10). Being a woman, being unemployed and belonging to an area of low vulnerability led to a worse perception of telemedicine. CONCLUSION: This questionnaire was a valid and reliable tool to assess the satisfaction of PC service users with telemedicine services. Perceptions of patient satisfaction decreased during COVID-19. Thus, TC seems to be a good option when the patients consider it to be a complementary rather than a substitute tool to follow-up their conditions.


Assuntos
COVID-19 , Telemedicina , Feminino , Humanos , COVID-19/epidemiologia , COVID-19/terapia , Satisfação do Paciente , Encaminhamento e Consulta , Espanha , Estudos Transversais , Pandemias , Reprodutibilidade dos Testes , Telefone
5.
Actas Dermosifiliogr ; 115(4): 387-392, 2024 Apr.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38065318

RESUMO

Communication with teenagers who are significantly affected by sexually transmitted infections (STIs) is essential for the sake of prevention. The aim of this study is to develop a specific questionnaire for surveying the degree of knowledge, behavior, and attitudes of current teenagers and young adults on STIs to come up with the proper training tools. We conducted the study following the Delphi method, a 2-round critical assessment score (from 1 to 9) of all domains and items. Only domains and items with median scores ≥8 were selected. A total of 8 panelists were involved in this survey. After establishing a median score ≥8, a total of 14 domains and 40 items were eventually selected. This is the first questionnaire ever conducted to study the knowledge, habits, and attitudes of contemporary teenagers and young adults on STIs, and stands as a valuable tool for future training on STI prevention in teenagers and young adults.


Assuntos
Comportamento Sexual , Infecções Sexualmente Transmissíveis , Humanos , Adolescente , Adulto Jovem , Conhecimentos, Atitudes e Prática em Saúde , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/prevenção & controle , Inquéritos e Questionários , Hábitos
6.
Actas Dermosifiliogr ; 115(4): T387-T392, 2024 Apr.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38331169

RESUMO

Communication with teenagers who are significantly affected by sexually transmitted infections (STIs) is essential for the sake of prevention. The aim of this study is to develop a specific questionnaire for surveying the degree of knowledge, behavior, and attitudes of current teenagers and young adults on STIs to come up with the proper training tools. We conducted the study following the Delphi method, a 2-round critical assessment score (from 1 to 9) of all domains and items. Only domains and items with median scores ≥8 were selected. A total of 8 panelists were involved in this survey. After establishing a median score ≥8, a total of 14 domains and 40 items were eventually selected. This is the first questionnaire ever conducted to study the knowledge, habits, and attitudes of contemporary teenagers and young adults on STIs, and stands as a valuable tool for future training on STI prevention in teenagers and young adults.


Assuntos
Comportamento Sexual , Infecções Sexualmente Transmissíveis , Humanos , Adolescente , Adulto Jovem , Conhecimentos, Atitudes e Prática em Saúde , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/prevenção & controle , Inquéritos e Questionários , Hábitos
7.
Actas Dermosifiliogr ; 2024 Feb 19.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38382749

RESUMO

INTRODUCTION: Rosacea is a chronic disease negatively impacting the patients' quality of life and mental health. The Rosacea Quality of Life (RosaQoL) scale could be a useful tool to monitor patients while on therapy vs rosacea, as it measures the impact on quality of life and helps individualize treatment to meet the patients' needs. RosaQoL is a validated scale that can be completed within a few minutes. MATERIALS AND METHODS: The original scale was translated and back translated by 2 native translators, with input from an expert committee when necessary. This version was tested on 21 patients to ensure proper understanding. Psychometric characteristics and validity were determined using various measures (sensitivity and specificity via ROC curve and internal consistency via Cronbach's alpha). The correlation between RosaQoL and SF-12 scales was assessed using Pearson correlation coefficients. RESULTS: A total of 531 participants responded to the scale (481 with rosacea and 50 controls). The scale demonstrated excellent sensitivity and specificity (ROC curve, 0.96; 95%CI, 0.92-0.99) and high internal consistency (Cronbach's alpha, 0.96). RosaQoL correlated with SF-12. A higher score on the RosaQoL scale was associated with worse quality of life in all dimensions of the SF-12 scale. CONCLUSIONS: The Spanish version of the RosaQoL scale exhibits psychometric characteristics, which are similar to the original scale. Also, the RosaQoL scale is useful to assess the quality of life of patients with rosacea.

8.
Infant Ment Health J ; 44(2): 240-254, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36857469

RESUMO

The Parental Reflective Functioning Questionnaire (PRFQ) provides an efficient way to measure a parent's capacity to recognize their child's mental states and to understand the relationship between underlying mental states and behavior. To date, limited work evaluates its psychometric properties beyond initial validation studies. Here we examined the reliability and validity of the PRFQ in three samples of varying clinical risk (e.g., community sample, previous mental health diagnosis, substance use disorder diagnosis). Across samples, the majority (e.g., 75%-78%) of mothers identified as White; all mothers were from the USA. We compared the PRFQ to task-based measures of mentalization, the Parent Development Interview (PDI), and measures of the parent-child relationship. The PRFQ was a reliable measure across samples, and it was associated in theoretically consistent ways with task-based measures of mentalization. Parental RF across the PDI and PRFQ were not highly correlated in a sample of mothers with substance use disorders. Existing RF measures may be tapping into a different component of the broader construct of parental reflective functioning (PRF). The PRFQ was further validated by demonstrating relationships with parent-report measures of the parent-child relationship. Taken together, these findings provide additional support for the reliability and validity of the PRFQ.


El Cuestionario del Funcionamiento con Reflexión del Progenitor (PRFQ) aporta una manera eficaz de medir la capacidad del progenitor para reconocer los estados mentales de su niño y comprender la relación entre los estados mentales subyacentes y el comportamiento. A la fecha, un trabajo limitado evalúa sus propiedades sicométricas más allá de los estudios de validación inicial. Aquí examinamos la confiabilidad y validez del PRFQ en tres grupos muestra de riesgo clínico variado (v.g. grupo comunitario, previa diagnosis de salud mental, diagnosis de trastorno por uso de sustancias). A través de los grupos muestra, la mayoría (v.g., 75-78%) de las madres se identifican como blancas; todas las madres eran de los Estados Unidos. Comparamos el PRFQ con medidas de mentalización basadas en tareas, la Entrevista del Desarrollo del Progenitor (PDI), y medidas de la relación progenitor-niño. El PRFQ fue una medida confiable a lo largo de los grupos muestra, y se asoció de maneras teoréticamente consistentes con las medidas de mentalización basadas en tareas. El funcionamiento con reflexión del progenitor a lo largo del PDI y PRFQ no se correlacionaron altamente en un grupo muestra de madres con trastornos de uso de sustancias. Las medidas del funcionamiento con reflexión existentes pudieran sacar provecho de un componente diferente de la más amplia edificación del funcionamiento con reflexión del progenitor. Se validó además el PRFQ por medio de demostrar las relaciones con las medidas auto reportadas por el progenitor de la relación progenitor-niño. Tomados en conjunto, estos resultados aportan un apoyo adicional para la confiabilidad y validez del PRFQ.


Le Questionnaire de Fonctionnement de Réflexion Parental (QFRP) offre une manière efficace de mesurer la capacité d'un parent à reconnaître les états mentaux de leur enfant et de comprendre la relation entre les états mentaux sous-jacents et le comportement. Jusqu'à présent peu d'études ont évalué ses propriétés psychométriques au-delà des études initiales de validation. Nous examinons ici la fiabilité et la validité du QFRP chez trois échantillons de risque clinique varié (soit un échantillon communautaire, un diagnostic de santé mentale précédent, un diagnostic de trouble lié à l'usage d'une substance). Au travers des échantillons la majorité (c'est-à-dire 75-78%) des mères se sont identifiées comme étant blanches et toutes les mères étaient américaines (des USA). Nous avons comparé le QFRP à des mesures de mentalisation faites à partir d'une tâche, à l'Entretien de Développement du Parent (en anglais Parent Development Interview, soit PDI), et à des mesures de la relation parent-enfant. Le QFRP s'est avéré être une mesure fiable au travers des échantillons et était lié de manières théoriquement cohérentes à des mesures de mentalisation (basées sur des tâches). Le FR parental au travers du PDI et le QFRP n'étaient pas fortement liés chez un échantillon de mères avec un trouble lié à l'usage d'une substance. Il est possible que les mesures FR qui existent puisent dans un composant différent de la structure plus large du fonctionnement de réflexion parental, Le QFRP a été en outre validé par la démonstration de la relation entre les mesures rapportées par les parents de la relation parent-enfant. Pris dans l'ensemble ces résultats offrent un soutien supplémentaire pour la fiabilité et la validité du QFRP.


Assuntos
Mães , Pais , Feminino , Humanos , Autorrelato , Reprodutibilidade dos Testes , Pais/psicologia , Mães/psicologia , Inquéritos e Questionários
9.
Infant Ment Health J ; 44(3): 387-405, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36864697

RESUMO

Parental reflective functioning (PRF) is the capacity to focus on feelings and experiences in oneself as a parent and in the child. Research has demonstrated that, the better the PRF the better outcomes for the child. This paper evaluated the Danish version of the prenatal parental reflective functioning questionnaire (P-PRFQ). We used data from a cluster-randomized trial of pregnant women recruited from Danish general practice. The sample included 605 mothers. Factor structure and internal consistency were investigated. Linear regression analysis was used to examine the associations between the P-PRFQ score and the five most predictive variables. The confirmatory factor analyses supported the three-factor model. The P-PRFQ had moderate internal consistency. The regression analysis showed a decrease in the P-PRFQ score with increasing age, increasing parity, current employment, better self-reported health, lower anxiety score, and fewer negative life events with persistent impact. The directions of the associations between P-PRFQ score and the predictive variables were opposite of what was hypothesized raising questions about whether the P-PRFQ can be used as an early pregnancy screening tool assessing prenatal PRF. Further validation studies are required to assess the extent to which the P-PRFQ truly measures reflective functioning.


El funcionamiento con reflexión de los padres es la capacidad de enfocarse en sentimientos y experiencias en uno mismo como progenitor y en el niño. La investigación ha demostrado que mientras mejor es el funcionamiento con reflexión, mejores son los resultados para el niño. Este ensayo evalúa la versión danesa del cuestionario prenatal del funcionamiento con reflexión de los progenitores (P-PRFQ). Usamos datos de un ensayo con un grupo al azar de mujeres embarazadas reclutadas de la práctica general danesa. El grupo muestra estaba compuesto de 605 madres. Se investigaron la estructura de factores y la consistencia interna. Se usaron análisis de regresión lineal para examinar la asociación entre los puntajes del P-PRFQ y las cinco variables más predictivas. Los análisis de factores confirmatorios apoyaron el modelo de tres factores. El P-PRFQ presentó una consistencia interna moderada. Los análisis de regresión mostraron una baja en los puntajes del P-PRFQ con el aumento de la edad, el aumento de la paridad, el empleo actual, una mejor auto reportada salud, más bajo puntaje de ansiedad y menos eventos negativos en la vida con impacto persistente. Las direcciones de las asociaciones entre el puntaje del P-PRFQ y las variables predictivas resultaros lo opuesto de la hipótesis propuesta, lo cual genera preguntas sobre si se puede usar el P-PRFQ como una herramienta de examen temprano del embarazo para evaluar el funcionamiento con reflexión prenatal de los progenitores. Se requieren estudios posteriores de validación para evaluar hasta qué punto el P-PRFQ mide verdaderamente el funcionamiento con reflexión.


La fonction réflexive parentale est la capacité à se focaliser sur ses propres sentiments et ses expériences en tant que parent et chez l'enfant. Les recherches ont démontré que mieux fonctionne la fonction réflexive parentale, mieux s'avère le résultat pour l'enfant. Cet article a évalué la version danoise du questionnaire de la fonction réflexive parentale prénatale (P-PRFQ). Nous avons utilisé des données d'un essai randomisé par grappes de femmes enceintes recrutées dans un service de médecine générale au Danemark. L'échantillon a inclus 605 mères. La structure de facteur et la cohérence interne ont fait l'objet des recherches. Une analyse par régression linéaire a été utilisée afin d'examiner les liens entre le score P-PRFQ et les cinq variables les plus prédictives. Les analyses factorielles confirmatoires ont soutenu le modèle à trois facteurs. Le P-PRFQ a eu une cohérence internet. L'analyse par régression a montré une baisse dans le score P-PRFQ avec un âge plus avancé, une parité augmentée, un emploi courant, une meilleure santé auto-rapportée, un score d'anxiété plus bas et moins d'événements négatifs de la vie ayant un impact persistent. Les directions des liens entre le score P-PRFQ et les variables prédictives étaient à l'opposé de l'hypothèse, soulevant des questions sur si le P-PRFQ peut être utilisé en tant qu'outil de dépistage au début de la grossesse pour évaluer la fonction réflexive parentale prénatale. Des études de validation supplémentaires sont nécessaires pour évaluer dans quelle mesure le P-PRFQ mesure vraiment la fonction réflexive.


Assuntos
Mães , Pais , Criança , Humanos , Feminino , Gravidez , Inquéritos e Questionários , Autorrelato , Dinamarca
10.
Aten Primaria ; 55(4): 102599, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36905788

RESUMO

OBJECTIVE: This study aimed to develop the Brazilian instrument for assessing eating disorders in children and adolescents and test its psychometric quality using item response theory (IRT). DESIGN: Cross-sectional study. PARTICIPANTS: Participants aged between five and twelve years old of both sexes. MAIN MEASURES: IRT logistic model of two parameters was used to evaluate the item's severity and discrimination and test information curve of symptoms of eating disorders' latent trait symptoms. Content validity and reliability were also assessed. The IRT evaluation suggested that the instrument contained items that performed differently concerning severity, discrimination, and test information curve presented good accuracy. RESULTS: There was agreement on the clarity of language (83.3%) and theoretical relevance (91.7%), indicating good content validity. The value of the Cronbach's Alpha was 0.63 (95% confidence interval), and the result of the Spearman-Brown test was 0.65. CONCLUSION: These results indicate good performance of the screening tool in assessing the level of eating disorders in children and adolescents.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos , Masculino , Feminino , Humanos , Criança , Adolescente , Pré-Escolar , Brasil , Reprodutibilidade dos Testes , Estudos Transversais , Inquéritos e Questionários , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Psicometria
11.
Aten Primaria ; 55(8): 102653, 2023 08.
Artigo em Espanhol | MEDLINE | ID: mdl-37216881

RESUMO

OBJECTIVE: To assess the prevalence of psychopathological symptoms among Saharawi refugees and the influence of sociodemographic factors on the phenotypic expression of mental disorders. DESIGN: Cross-sectional descriptive study. LOCATION: Primary and hospital health care. PARTICIPANTS: 383 participants over 18 years of age, 59.8% women and 40.2% men, with a mean age of 37.2 (SD = 13.0), from the Laayoune camp, and from the Rabuni National Hospital. METHODOLOGY: A descriptive, cross-sectional and analytical study was carried out between January and August 2017. Participants were selected by consecutive sampling. The main variable was the presence of mental symptoms, measured with the Goldberg General Health Questionnaire - 28. A descriptive analysis of each sociodemographic variable (age, sex, educational level, occupation) and its association with the main variable was carried out using Logistic regression. RESULTS: 43.3%, 95%CI (38.4-48.3) obtained a score that suggests the presence of mental symptoms. Women presented a mean score higher than men, in subscales A (somatic symptoms) and in subscale B (anxiety). Age over 50 years and having no educational level were associated with a higher probability of having mental symptoms. CONCLUSIONS: The study shows that the prevalence of mental symptoms among Saharawi refugees is high, and reinforces the need for more scientific research in the field of mental health to put the prevention of mental disorders and the promotion of mental health in the focus of health policy.


Assuntos
Transtornos Mentais , Refugiados , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Argélia/epidemiologia , Estudos Transversais , Nível de Saúde , Transtornos Mentais/epidemiologia , Prevalência , Refugiados/psicologia , Inquéritos e Questionários
12.
Aten Primaria ; 55(12): 102739, 2023 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-37690336

RESUMO

OBJECTIVES: Design, construction and validation of a self-completion test that allows the Family Physician (FP) to assess the extent to which he/she integrates person-centred care (PCC) in his/her clinical practice. DESIGN: Qualitative. Questionnaire design. LOCATION: Primary care. PARTICIPANTS: Two hundred and fourteen family and community medicine physicians and residents, from 62 of the 80 health centres in the autonomous community of Murcia (Spain). METHODS: Construction of a questionnaire from a bank of 873 items from a systematic review and a Delphi study. Review by PCC panel of experts (8). Cognitive pretest with 10 FP. Doctors from 62 health centres were invited to participate. With the responses we measured reliability, validity and feasibility. RESULTS: The final questionnaire contains 37 items. We measured reliability through internal consistency with a Cronbach's alpha of .915. For construct validity, the appropriate Bartlett's test of sphericity and the Kaiser-Mayer-Olkin measure of .889 allowed us to carry out a factor analysis with the extraction of nine factors (Kaiser's rule) with five main factors (Scree test) whose items coincide with the dimensions proposed by the experts. To assess its feasibility we considered the response rate of 31.15%, the response time of 17minutes 23seconds and only .9% of respondents considered the questionnaire long or complex. CONCLUSIONS: The ACPAPS questionnaire is a reliable, valid and feasible tool to assess PCC in FM, which has multiple and far-reaching applications.


Assuntos
Assistência Centrada no Paciente , Médicos de Família , Feminino , Humanos , Masculino , Análise Fatorial , Reprodutibilidade dos Testes , Inquéritos e Questionários
13.
Actas Dermosifiliogr ; 114(4): T299-T307, 2023 Apr.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-36868511

RESUMO

BACKGROUND: Teenagers' Quality of Life (T-QoL) is an age-specific measure to assess QoL of teenagers suffering from different skin diseases. A validated Spanish language version is lacking. We present the translation, cultural adaptation and validation of the T-QoL into Spanish. METHODS: A prospective study with 133 patients (between 12 and 19 years old), attended at the dermatology department of Toledo University Hospital, Spain (September 2019-May 2020), was carried out for the validation study. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines were used for the translation and cultural adaptation. We evaluated the convergent validity with the Dermatology Life Quality Index (DLQI), the Children's Dermatology Life Quality Index (CDLQI) and with a Global Question (GQ) on self-assessed disease severity. We also analysed internal consistency and reliability of the T-QoL tool and confirmed its structure with a factor analysis. RESULTS: Global T-QoL scores significantly correlated with the DLQI and the CDLQI (r = 0.75) and with the GQ (r = 0.63). The confirmatory factor analysis showed optimal fit for the bi-factor model and an adequate fit for the correlated three-factor model. Reliability indicators were high (Cronbach's α = 0.89; Guttman's Lambda 6 index = 0.91; Omega ω = 0.91) and test-retest showed a high stability (ICC = 0.85). The results were consistent with those found by the authors of the original test. CONCLUSION: Our Spanish version of the T-QoL tool is valid and reliable to assess QoL of Spanish-speaking adolescents with skin diseases.


Assuntos
Qualidade de Vida , Dermatopatias , Inquéritos e Questionários , Humanos , Adolescente , Dermatopatias/psicologia , Idioma , Reprodutibilidade dos Testes , Estudos Prospectivos , Masculino , Feminino , Adulto Jovem , Espanha
14.
Actas Dermosifiliogr ; 114(4): 299-307, 2023 Apr.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-36690147

RESUMO

BACKGROUND: Teenagers' Quality of Life (T-QoL) is an age-specific measure to assess QoL of teenagers suffering from different skin diseases. A validated Spanish language version is lacking. We present the translation, cultural adaptation and validation of the T-QoL into Spanish. METHODS: A prospective study with 133 patients (between 12 and 19 years old), attended at the dermatology department of Toledo University Hospital, Spain (September 2019-May 2020), was carried out for the validation study. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines were used for the translation and cultural adaptation. We evaluated the convergent validity with the Dermatology Life Quality Index (DLQI), the Children's Dermatology Life Quality Index (CDLQI) and with a Global Question (GQ) on self-assessed disease severity. We also analysed internal consistency and reliability of the T-QoL tool and confirmed its structure with a factor analysis. RESULTS: Global T-QoL scores significantly correlated with the DLQI and the CDLQI (r=0.75) and with the GQ (r=0.63). The confirmatory factor analysis showed optimal fit for the bi-factor model and an adequate fit for the correlated three-factor model. Reliability indicators were high (Cronbach's α=0.89; Guttman's Lambda 6 index=0.91; Omega ω=0.91) and test-retest showed a high stability (ICC=0.85). The results were consistent with those found by the authors of the original test. CONCLUSION: Our Spanish version of the T-QoL tool is valid and reliable to assess QoL of Spanish-speaking adolescents with skin diseases.


Assuntos
Qualidade de Vida , Dermatopatias , Criança , Humanos , Adolescente , Adulto Jovem , Adulto , Estudos Prospectivos , Reprodutibilidade dos Testes , Inquéritos e Questionários , Idioma , Traduções
15.
Actas Dermosifiliogr ; 114(6): 488-493, 2023 Jun.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-36935038

RESUMO

BACKGROUND: The 7-item RECAP (Recap of Atopic Eczema) questionnaire is used to assess the control of different degrees of eczema severity in patients of all ages. Long-term control of eczema is one of the 4 core outcome domains to be assessed in clinical trials of eczema therapies. After the RECAP was developed in the United Kingdom, it was translated into Chinese, German, Dutch, and French. OBJECTIVES: To produce a validated Spanish version of the RECAP questionnaire and, secondarily, to test its content validity in a group of Spanish patients with atopic eczema. MATERIAL AND METHODS: In a 7-step process we produced 2forward translations and 1back translation of the RECAP questionnaire. Experts then held two meetings to reach consensus and draft a Spanish version of the questionnaire. Fifteen adult patients with atopic eczema were interviewed to evaluate the comprehensibility, comprehensiveness, and relevance of the drafted items. These patients also completed the Atopic Dermatitis Control Tool (ADCT), the Dermatology Life Quality Index (DLQI), and the Patient-Oriented Eczema Measure (POEM). Stata software (version 16) was then used to explore the correlations between the patients' scores on these tools and the RECAP. RESULTS: The patients found the Spanish version of the RECAP to be comprehensible and easy to answer. We observed a strong correlation between results on the Spanish RECAP and the ADCT, and highly significant correlations between the RECAP and the DLQI and POEM tools. CONCLUSIONS: The culturally adapted Spanish version of the RECAP is linguistically equivalent to the original version of the questionnaire. RECAP scores correlate highly with other patient-reported outcome measures.


Assuntos
Dermatite Atópica , Eczema , Adulto , Humanos , Dermatite Atópica/terapia , Qualidade de Vida , Inquéritos e Questionários , Medidas de Resultados Relatados pelo Paciente , Índice de Gravidade de Doença
16.
Gastroenterol Hepatol ; 45(7): 524-534, 2022.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-34428475

RESUMO

OBJECTIVE: Measurement of patient-perceived outcomes in inflammatory bowel disease (IBD) care is becoming increasingly important. A simple and validated tool exists in English for this purpose, the "IBD-Control". Our aim is to translate it into Spanish, adapt and validate it. PATIENTS AND METHODS: The IBD-Control was translated into the Spanish instrument "EII-Control" and prospectively validated. Patients completed the EII-Control and other questionnaires that served as baseline comparators. The gastroenterologist performed a global assessment of the disease, calculated activity indices and recorded treatment. A subgroup of patients repeated the entire assessment at a second visit. The usefulness of IBD-Control summary scales (IBD-Control-8 and IBD-Control-VAS) was also analysed. RESULTS: A total of 249 IBD patients were included (101 repeated the second visit). Psychometric standards of the test: internal consistency: Cronbach's α for EII-Control 0.83 with strong correlation between EII-Control-8 and EII-Control-EVA (r=0.5); reproducibility: intra-class correlation 0.70 for EII-Control; construct validity: moderate to strong correlations between IBD-Control, IBD-Control-8 and IBD-Control-VAS versus comparators; discriminant validity: P<.001; sensitivity to change: same response as quality of life index. Sensitivity and specificity at cut-off point 14 of 0.696 and 0.903, respectively, to determine quiescent status. CONCLUSIONS: The IBD-Control is a valid instrument to measure IBD-Control from the patient's perspective in our environment and culture. Its simplicity makes it a useful tool to support care.


Assuntos
Doenças Inflamatórias Intestinais , Qualidade de Vida , Doença Crônica , Humanos , Doenças Inflamatórias Intestinais/terapia , Reprodutibilidade dos Testes , Inquéritos e Questionários
17.
Infant Ment Health J ; 42(2): 188-205, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33455023

RESUMO

There is a lack of instruments assessing child-caregiver attachment relationships in early childhood to be used in attachment-based practice, in particular from a caregiver's perception, which is an important factor of clinical importance to take into account in parenting interventions targeting young children. Therefore, the 48-item Attachment Relationship Inventory-Caregiver Perception 2-5 years (ARI-CP 2-5) was developed. Survey data of 446 caregivers of 2- to 5-year-old children were collected, and a subsample of 83 caregivers participated in an observation study. Confirmatory factor analysis confirmed a four-factor structure of secure, avoidant, ambivalent, and disorganized attachment relationship. Indications of configural, metric, and scalar invariance were found for caregivers' and children's sex, children's age, and population (clinical vs. general population). The four scales showed sufficient internal consistency and significant associations with children's psychopathology, caregivers' general attachment representations, caregivers' mind-mindedness, and population type. Moreover, preliminary evidence for convergent validity with observational attachment measures was found. It is concluded that the ARI-CP 2-5 is a valid instrument that can be used as part of the screening and assessment of insecure attachment relationships.


Hacen falta instrumentos que evalúen las relaciones de afectividad niño-cuidador en la temprana niñez para ser usados en la práctica que se basa en la afectividad, en particular desde la perspectiva del cuidador, lo cual es un factor clave de importancia clínica para tomar en cuenta en las intervenciones de crianza que se enfocan en niños pequeños. Por tanto, se desarrolló el Inventario de la Relación Afectiva - Percepción del Cuidador 2-5 años, que consta de 48 aspectos (ARI-CP 2-5). Se recogió información de encuesta de 446 cuidadores de niños de 2 a 5 años de edad, y un subgrupo muestra de 83 cuidadores participó en un estudio de observación. Los análisis de factores confirmatorios corroboraron una estructura de cuatro factores de la relación de afectividad que es segura, la que evita, la ambivalente y la desorganizada. Se encontraron indicaciones de invariabilidad en el aspecto configuracional, métrico y de escala en cuanto al género sexual de los cuidadores y del niño, la edad del niño, y la población (clínica y general). Las cuatro escalas mostraron una suficiente consistencia interna y asociaciones significativas con la sicopatología de los niños, las representaciones generales de afectividad del cuidador, la conciencia mental de los cuidadores, así como el tipo de población. Es más, se encontró una evidencia preliminar para la validez convergente con las medidas de afectividad de observación. Se concluye con que el ARI-CP 2-5 es un instrumento válido que puede usarse como parte de la detección y evaluación de las relaciones de afectividad inseguras.


Il y a un manque d'instruments évaluant les relations d'attachement enfant-aidant naturel dans la petite enfance pouvant être utilisés dans une pratique basée sur l'attachement, en particulier sur la perception de l'aidant naturel, qui est un facteur important de l'importance clinique à prendre en compte dans les interventions de parentages ciblant les jeunes enfants. Par conséquent l'Inventaire de 48 articles de la Relation d'Attachement - Perception de l'Aidant Naturel 2-5 ans (abrégé en anglais ARI-CP 2-5) a été développé. Les données de sondage de 446 aidants naturels d'enfants de 2 à 5 ans ont été recueillies et un sous-échantillon de 83 aidants naturels ont participé à une étude d'observation. Une analyse factorielle confirmatoire a confirmé une structure à quatre facteurs de la relation d'attachement sécure, évitant, ambivalent et désorganisé. Des indications d'invariance configurale, métrique et scalaire ont été trouvées pour le sexe des aidants naturels et des enfants, l'âge des enfants, et la population (clinique par rapport à population générale). Les quatre échelles ont démontré une cohérence interne suffisante et des associations importantes avec la psychopathologie des enfants, les représentations de l'attachement générale des aidants naturels, l'esprit-qualité mentale et le type de population. De plus une preuve préliminaire de validité convergente ave les mesures observationnelles d'attachement a été trouvée. Nous concluons que l'ARI-CP 205 est un instrument valide qui peut être utilisé pour le dépistage et l'évaluation de relations d'attachement insécures.


Assuntos
Cuidadores , Percepção , Pré-Escolar , Análise Fatorial , Humanos , Psicometria , Inquéritos e Questionários
18.
Infant Ment Health J ; 42(1): 47-59, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32744756

RESUMO

This study aimed to explore the factor structure, reliability, and validity of a Korean translation of the Parental Reflective Functioning Questionnaire (PRFQ). The PRFQ consists of three subscales: prementalizing modes, certainty about mental states, and interest and curiosity in mental states. A convenience sample of 163 Korean parents completed the K-PRFQ. Exploratory factor analysis showed three factors mapped on to the original PRFQ factors, but items from the original prementalizing modes subscale clustered into two additional factors. Data from a subsample (n = 67) showed that the certainty about mental states and interest and curiosity in mental states subscales correlated positively with more optimal self-reported parenting. We discuss the validity of using the PRFQ in collectivistic cultures.


Este estudio se propuso explorar la estructura de factores, la confiabilidad y la validez de una traducción al coreano del Cuestionario de Funcionamiento de Reflexión del Progenitor (PRFO; Luyten, Mayes, Nijssens y Fonagy, 2017). El PRFQ consiste en tres escalas: Modos de Pre-mentalización, la Certeza acerca de estados mentales y el Interés y curiosidad por los estados mentales. Un conveniente grupo muestra de 163 progenitores coreanos completó el K-PRFQ. Los exploratorios análisis de factores mostraron tres factores identificados dentro de los factores del PRFQ original, sin embargo, temas de la sub-escala original de Modos de Pre-mentalización se agruparon en dos factores adicionales. Los datos provenientes de un sub-grupo muestra (n = 67) mostraron que la Certeza acerca de estados mentales y el Interés y curiosidad por los estados mentales se correlacionaron positivamente con una auto-reportada más óptima crianza. Discutimos la validez de usar el PRFQ en culturas colectivistas.


Cette étude s'est donné pour but d'explorer le facteur structure, fiabilité et validité d'une traduction coréenne du Questionnaire de Fonctionnement Réflexif Parental (PRFQ; Luyten, Mayes, Nijssens, & Fonagy, 2017). Le PRFQ consiste en trois sous-échelles: Modes pré-mentalisation, Certitude sur les états mentaux, et Intérêt et curiosité dans les états mentaux. Un échantillon de convenance de 163 parents coréens a rempli le K-PRFQ. Une analyse exploratoire de facteur a montré trois facteurs mappés sur les facteurs d'origine du PRFQl, mais des aspects de la sous-échelle des modes de pré-mentalisation se sont regroupés en deux facteurs de plus. Les données d'un sous-échantillon (n = 67) ont montré que la Certitude sur les états mentaux et les sous-échelles d'Intérêt et la curiosité dans les états mentaux étaient en corrélation positive avec un parentage auto-rapporté optimal. Nous avons discuté la validité de l'utilisation du PRFQ dans les cultures collectivistes.


Assuntos
Poder Familiar , Pais , Humanos , Reprodutibilidade dos Testes , República da Coreia , Inquéritos e Questionários
19.
Infant Ment Health J ; 42(5): 655-671, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34505721

RESUMO

The mother's bond to her baby starts to develop during pregnancy, and it is related to the baby's attachment. We study how the mother's prenatal expectations of her unborn baby, the mother's adult relationships, and postnatal psycho-social factors (stress, depression, and anxiety) are related to the risk of bonding disturbance. The study comprised 1398 mothers and their unborn babies assessed both during pregnancy and when the babies were 3 months old (47.7% girls). The mother's risk of bonding disturbance was investigated using Brockington's Postpartum Bonding Questionnaire. According to the results, 71 (5.1%) of all the mothers in the study had a risk of a bonding disturbance. In a final adjusted logistic regression model, the most important risk factors were the mother's inability to form positive expectations about relationships with the baby during the third trimester of pregnancy (AOR = 7.78, p ≤ .001), maternal postnatal stress (AOR = 4.95, p ≤ .001) and maternal postnatal depression (AOR = 3.46, p ≤ .01). The results challenge healthcare professionals to screen pregnant mothers to identify at-risk groups for post-partum bonding disturbances. Intervention programs to prevent the development of bonding disturbances, and thus their possible serious consequences for children's development, should be considered.


La unión afectiva entre la madre y su bebé comienza a desarrollarse durante el embarazo y está relacionado a la afectividad del bebé. Estudiamos cómo las expectativas prenatales que la madre tenía de su bebé aún no nacido, las relaciones adultas de la madre, así como los factores sicosociales (estrés, depresión y ansiedad) están relacionados con la alteración de la unión afectiva. El estudio incluyó a 1,398 madres y sus no nacidos bebés evaluados ambos durante el embarazo y cuando los bebés tenían tres meses de nacidos (47.7% niñas). El riesgo de la madre de alteraciones en la unión afectiva fue investigado usando el Cuestionario Brockington sobre la Unión Afectiva Posterior al Parto. De acuerdo con los resultados, 71 (5.1%) de todas las madres en el estudio presentaban un riesgo de alteración de la unión afectiva. En un modelo final de regresión logístico ajustado, los más importantes factores de riesgo fueron la inhabilidad de la madre de formar expectativas positivas acerca de las relaciones con el bebé durante el tercer trimestre del embarazo (AOR = 7.78, p < .001), el estrés materno postnatal (AOR = 4.95, p < .001) y la depresión materna postnatal (AOR = 3.46, p < .01). Los resultados presentan un reto a los profesionales del cuidado de la salud para examinar a mujeres embarazadas con el fin de identificar grupos bajo riesgo de alteraciones en la unión afectiva posterior al parto. Se deben considerar programas de intervención para prevenir el desarrollo de alteraciones en la unión afectiva y, por tanto, posibles serias consecuencias para el desarrollo de los niños.


Le lien de la mère avec son bébé commence à se développer durant la grossesse, et est lié à l'attachement du bébé. Nous étudions la manière dont les attentes prénatales que la mère se fait de son bébé à naître, les relations adultes de la mère, et les facteurs postnatals psycho-sociaux (stress, dépression, anxiété) sont liés au risque de trouble du lien. L'étude a compris 1398 mères et leurs bébé à naître évalués à la fois durant la grossesse et quand les bébés avaient trois mois (47,7% de filles). Le risque de trouble du lien de la mère a fait l'objet de l'étude, au moyen du Questionnaire du Lien Postpartum de Brockington. Selon les résultats, 71 (soit 5,1%) de toutes les mères de l'étude avaient un risque de trouble du lien. Dans un modèle de régression logistique ajusté final les facteurs de risque les plus importants étaient l'incapacité de la mère à former des attentes positives sur les relations avec le bébé durant le troisième trimestre de la grossesse (AOR - 7,78, p ≤,001), le stress postnatal maternel (AOR = 4,95, p ≤,001) et la dépression postnatale maternelle (AOR = 3,46, p ≤,01). Les résultats défient les professionnels de la santé de dépister les mères enceintes afin d'identifier les groupes à risque de troubles du lien postpartum. Des programmes d'intervention destinés à prévenir le développement de troubles du lien ainsi que leurs conséquences sévères pour le développement des enfants devraient être considérés.


Assuntos
Motivação , Fatores Sociais , Adulto , Criança , Feminino , Humanos , Lactente , Masculino , Relações Mãe-Filho , Apego ao Objeto , Gravidez , Fatores de Risco
20.
Gac Med Mex ; 157(1): 64-69, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34125819

RESUMO

INTRODUCTION: In Mexico, neither the 36-item Short Form Health Survey (SF-36) nor the Bariatric Analysis and Reporting Outcome System (BAROS) instruments have been used to assess quality of life (QoL) before and after bariatric surgery (BS). OBJECTIVE: To describe changes in QoL using the SF-36 and BAROS questionnaires in patients with severe obesity before and after BS. METHODS: Clinical and anthropometric data of patients undergoing bariatric surgery between 2015 and 2016 were collected. Statistical significance was considered with a p-value < 0.05. RESULTS: 230 patients were analyzed, 98 before and 132 and after BS; most were females (81 %). Initial body mass index was 48 kg/m2 (44-53). SF-36-measured QoL showed an increase in the physical component score from 43 to 54.2 points (p < 0.001), and in the mental component, from 53.3 to 56.6 points after BS. With BAROS, 98.5 % showed good to excellent QoL results within the first three months after BS. CONCLUSION: When measured with the SF-36 and BAROS questionnaires, QoL of Mexican patients with severe obesity was found to improve after BS.


INTRODUCCIÓN: En México no se han utilizado los instrumentos Shorth Form 36 Items (SF-36) ni Baryatric Assesment Reporting Outcomes System (BAROS) para evaluar la calidad de vida (CV) antes y después de la cirugía bariátrica (CB). OBJETIVO: Describir los cambios en la CV con los cuestionarios SF-36 y BAROS, en pacientes con obesidad severa antes y después de la CB. MÉTODOS: Se recolectaron los datos clínicos y antropométricos de pacientes sometidos a cirugía baríatrica entre 2015 y 2016. Se consideró con significación estadística una p < 0.05. RESULTADOS: Se analizaron 230 pacientes, 98 y 132 antes y después de la CB; la mayoría fue del sexo femenino (81 %). El índice de masa corporal inicial fue de 48 kg/m2 (44-53). La CV medida con el SF-36 demostró un incremento en la puntuación del componente físico de 43 a 54.2 (p < 0.001) y en el componente mental, de 53.3 a 56.6 después de la CB. Con BAROS, en 98.5 % se registraron resultados buenos a excelentes en la CV en los primeros tres meses. CONCLUSIÓN: Al ser medida con los cuestionarios SF-36 y BAROS se definió que la CV de los pacientes mexicanos con obesidad severa mejora después de la CB.


Assuntos
Cirurgia Bariátrica , Obesidade Mórbida , Qualidade de Vida , Adulto , Cirurgia Bariátrica/psicologia , Índice de Massa Corporal , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , México , Pessoa de Meia-Idade , Obesidade Mórbida/psicologia , Obesidade Mórbida/cirurgia , Período Pós-Operatório , Período Pré-Operatório
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