MIDITRA Protocol: Psychological Intervention in Adults with Difficult-to-Treat Migraine: An Open Study.

Migraines constitute a neurological disorder characterized by severe and recurrent headaches, significantly impacting the quality of life especially when unresponsive to treatment. This is particularly pronounced in individuals with difficult-to-treat migraines, leading to heightened physical and psychosocial disability. The study aims to design and implement a psychological intervention protocol (MIDITRA) focused on improving the physical and psychological well-being of those suffering from difficult-to-treat migraines. The efficacy of this intervention will be assessed in a pilot study involving 30 adults with chronic, difficult-to-treat migraines. This is an open study, adopting a longitudinal experimental design, and involving inter-subject comparisons between an experimental group (receiving psychological treatment) and a control group (without treatment), being assessed at two post-treatment time points. Additionally, an intra-subject analysis will be conducted, comparing repeated measures to assess changes within each subject before (with two pre-treatment measurements) and after psychological treatment (with two post-treatment measurements). Treated patients will receive a 10-session group psychological intervention. The analysis will focus on the therapeutic benefits of applying the MIDITRA protocol, specifically aiming to reduce migraine-related disability, diminish the negative impact of headaches, enhance the quality of life, mitigate pain catastrophizing, increase life satisfaction, elevate positive affect, decrease negative affect, lower psychological stress, boost resilience, and reduce anxiety and depression.

Study of the emotional adjustment of the caregiver-patient dyad to bronchial asthma in adolescence.

AIM: This study aimed to investigate the impact of bronchial asthma-related factors on the emotional well-being of adolescents with bronchial asthma and their primary caregivers. BACKGROUND: Bronchial asthma is a common chronic disease in childhood and adolescence that can have a psychological impact on both patients and their primary caregivers. METHODS: The study used a cross-sectional design and included 150 patient-caregiver dyads diagnosed with bronchial asthma, aged between 12 and 16 years and collected between 2018 and 2020. It assessed the emotional adjustment of both patients and caregivers and recorded variables related to the disease. Qualitative and quantitative analyses were conducted to perform statistical analyses. RESULTS: Caregivers had higher anxiety and depression scores than patients. Good adherence to treatment was necessary for the emotional adjustment of the dyad. Controlled asthma, good adherence to treatment and a reduction in medical treatment were the primary predictors of emotional adjustment. CONCLUSIONS: The study highlights the importance of assessing anxiety and depression levels in both patients and caregivers because the presence of these symptoms can lead to the misuse of medication, inadequate inhalation techniques, the omission of medication and reduced confidence in controlling asthma symptoms.

Family bonds and personal factors in caregiver burden in patients at the end of life.

Family caregivers are defined as those who assume substantial responsibilities for the care of an ill loved one without formal health care training. This study aims to analyze the predictors of physical and emotional burden in caregivers of palliative patients using qualitative comparative analysis methodologies (QCA) and taking into account patient and caregiver personal and relational variables. A total of 125 caregivers of patients at the end of life were assessed using an ad hoc emotional and physical burden questionnaire and patient and caregiver personal and relational variables were recorded. Results indicate moderately high levels of both emotional and physical burden. Differences in burden are found only as a function of kinship. Emotional burden is positively associated with the use of physical health medication in the caregiver and kinship; meanwhile, physical burden is positively associated with time since diagnosis, patient functional independence, and economic problems. For the QCA models, several pathways predict the observed variance in the emotional and physical burden of family caregivers of patients at the end of life, based on patient, caregiver, and relationship variables. In conclusion, it is relevant to design intervention programs focused on patient-caregiver relationship to prevent the development of emotional and physical burden.

Longitudinal Study of Bereavement Outcomes Among Palliative Caregivers Mourners: Psychological Profiles in Prolonged Grief and Psychopathology.

Prolonged grief (PG) is a mental health condition characterized by severe distress following a loss. This study examines the roles of attachment styles, social support, stressful life events (SLEs), and pre-existing psychopathology in predicting PG and post-bereavement psychopathology among 74 caregivers of palliative patients. Using validated assessment tools, the study employed hierarchical regression and fuzzy-set qualitative comparative analysis (fsQCA) to identify predictors of prolonged grief and psychological outcomes over six months. Results showed that pre-existing psychopathology and PG risk predicted post-bereavement psychopathology, though not PG itself. Low social support and high SLEs were linked to worse outcomes, while strong social support and low stress predicted positive outcomes. These findings highlight the importance of multiple interacting factors in understanding grief and emphasize the need for interventions that enhance social support, manage stress, and address mental health conditions to reduce psychological distress in bereaved caregivers.

Quality of life in patients with asthma: Medical indicators and psychological variables.

BACKGROUND: Quality of life (QoL) is a widely studied term concerning asthma because it allows the impact of the disease on the patient's life to be assessed through the patient's perception. The study aims to analyze which asthma-related, psychological, and family variables affect the QoL of adolescents with asthma. DESIGN AND METHODS: This cross-sectional design involves 150 patients diagnosed with asthma aged between 12 and 16 years. The patients' emotional symptomatology, the threat of illness, self-esteem, bonds, quality of life, family, and disease variables were assessed. Statistical analyses were performed using QCA models. RESULTS: The results indicate that girls have a poorer QoL, and age is negatively associated. QCA models found that the variables that best explained the quality of life of these patients, in the case of the medical indicators, were control, good compliance, shorter diagnosis times, and improvement. Regarding psychological variables: a lower threat of illness, less emotional distress, and better parental mood explained the high QoL. CONCLUSIONS AND PRACTICAL IMPLICATIONS: Adolescent QoL is affected by variables related to their asthma that are beyond their control and other psychological and family variables that may increase the perception of their QoL.

Compassion in Spanish-speaking health care: A systematic review.

Altought compassionate care is an important factor in health care, remains an unmet need in patients. The studies have been carried out in Anglo-Saxon countries with cultural environments and health systems that are very different from Spanish-speaking contexts. The aim of this study to understand the conceptual, evaluation and clinical application nuances of compassion and compassionate care in Spanish-speaking health care settings, through a systematic review. A search of the scientific literature was carried out following the PRISMA guidelines in ProQuest Central, PubMed and Web Of Science, resulting in 295 studies, of which 27 were selected, based on the following inclusion criteria: the article studied or analyzed the construct of compassion in healthcare setting and the participants were Spanish speakers or the authors spoke of the construct in Spanish. Two blinded evaluators performed the study selection process using the Covidence tool. The agreement between evaluators was in all cases satisfactory. Different definitions of the construct have been identified, that they generally share: the recognition of suffering and the attempt to alleviate it. There are few studies that focus solely on the analysis of compassion, since other concepts appear that are associated with it, such as empathy and self-compassion. Further research is needed to obtain a better and greater understanding of compassionate care adapted to the perceptions of patients and health professionals in different socio-cultural contexts. In this way, instruments that measure compassionate care can be better developed and adjusted, and interventions aimed at promoting compassion can be properly assessed.

Quality of life in cancer survivorship: Sociodemographic and disease-related moderators.

RATIONALE: To identify high-risk survivors in order to provide appropriate care. PURPOSE: To analyse the quality of life (QOL) of cancer survivors using an instrument designed specifically for this population and considering different sociodemographic and disease-related characteristics as possible modulating variables. METHODS: The Quality of Life in Adult Cancer Survivors (QLACS) was filled out by a large and heterogeneous sample of disease-free post-treatment Spanish cancer survivors (N = 1862). RESULTS: QLACS scores were comparable to those obtained in other studies and indicative of worse QOL as a function of shorter elapsed time since the end of primary treatment. The best QOL was shown by prostate, and the worst by hematologic cancer survivors. Both systemic treatments (chemotherapy and hormone therapy) and the combination of radiotherapy and chemotherapy were associated with worse QOL. Likewise, younger age, female sex, unemployment status and not having a stable partner were associated with worse QOL. CONCLUSION: Greater understanding of the QOL experienced by the already large and continuously growing population of cancer survivors is relevant for guiding both clinical practice and health policy. In addition, knowing the risk factors associated with worse QOL facilitates the development of targeted prevention programmes for those survivors who need it the most.

Predicting health-related quality of life in Spanish adolescents with allergic rhinoconjunctivitis and bronchial asthma.

This study analyzed the predictive power of sociodemographic (age, sex) and medical variables (months since diagnosis and in treatment, immunotherapy, number of environmental allergens, food allergies or atopic dermatitistypes) on the quality of life of patients with rhinoconjunctivitis and bronchial asthma, using models based on comparative qualitative fuzzy analysis to compare them according to the pathology(s).Retrospective cross-sectional design.Sixty-four adolescents (65.60% boys) diagnosed with rhinoconjunctivitis and/or bronchial asthma aged between 12 and 16 years old (M= 14.02; SD = 1.45).The data were collected between February 2019 and January 2020 using the Brief Disease Perception Questionnaire (B-IPQ), the Adolescent Rhinoconjunctivitis Quality of Life Questionnaire (AdolRQoLQ) and the Respiratory Disease Questionnaire Self-administered and Standardized Chronicle (CRQ-SAS). Qualitative comparative analysis models (QCA) were used.In the QCA models, the various combinations indicated that the variables that predicted a higher quality of life for both rhinocojuntivitis symptoms and respiratory symptoms were receiving longer-term immunotherapy and a perceived lower threat of the disease. The consistencies of the models vary between 23-29%. In conclusion, the patients' QoL was explained by the presence of longer-term immunotherapy and a less threatening perception of the disease.Therefore, early multidisciplinary diagnosis and treatment is important.

Psychological aspects of pre-adolescents or adolescents with precocious puberty: A systematic review.

PROBLEM: Precocious puberty (PP) is an illness that appears when puberty, begins some years earlier than usual, provoking inferences in preadolescents and adolescents and their families. Therefore, the aim is to analyze if psychological consequences can be observed in groups of preadolescents or adolescents with PP. METHOD: A bibliographic search of the scientific literature was made following the PRISMA guide in the following databases: ProQuest, Psychinfo, Web Of Science, and Scopus. 592 studies were found, were uploaded to Covidence to make a screening, of which finally 6 were included for the revision according to the inclusion and exclusion criteria. Two independent evaluators made the search, selection, data extraction and quality evaluation of studies independently. The agreement degree between both was excellent in all of the cases. RESULTS: 211 preadolescents participated in total in all studies, of which 99 were preadolescents with PP, with a mean age of 8,94 years old. Studies evaluated so heterogeneous variables, such as psychopathology, self-image, neuropsychological and cognitive variables, and reasons to delay or stop PP. The quality of studies was moderated especially due to the low quality of the studies design, which were mostly transversal, and the representativity of the sample, being selected by convenience. CONCLUSIONS AND IMPLICATIONS: More research is needed to evaluate the psychological consequences of the PP diagnosis in pediatrics, and its protection factors, because none of the studies approached this question. We consider that it is necessary to increment the quality of these studies, and that these take a biopsychosocial perspective.

Adolescence and short stature: factors in adjustment to the diagnosis.

PURPOSE: Adolescence is a time of change when suffering from a medical condition such as short stature can impact the emotional well-being of adolescents. Our objective was to study the adjustment of adolescents with short stature (SS), analyzing the factors influencing it. METHOD: In this cross-sectional study, we evaluated 101 adolescents with SS from different hospitals in Valencia, Spain, using instruments validated for the sample: anxious and depressive symptomatology (as a diagnostic adjustment measure), psychopathology, self-esteem, physical self-concept, psychological well-being, and parenting styles. Descriptive analyses, t-tests for independent samples, Pearson correlations, hierarchical regressions, and fuzzy set qualitative comparative analysis models (fsQCA) were performed. RESULTS: Emotional (ß = 0.44; p = 0.001) and hyperactive (ß = 0.20; p = 0.001) symptoms predicted anxiety, emotional symptomatology (ß = 0.25; p = 0.022), self-esteem (ß = - 0.37; p = 0.001), and promotion of autonomy (ß = 0.30; p = 0.001) predicted depression, and hyperactivity (ß = 0.45; p = 0.001), self-esteem (ß = - 0.43; p = .001), and humor (ß = - 0.36; p = 0.001) predicted emotional distress. The fsQCA results show that none of the variables is a necessary condition for anxiety, depression, or emotional distress. However, different combinations of these variables are sufficient conditions to explain 85% of the high levels of anxiety, 81% of the low levels, 62% of the high levels of depression, 64% of the low levels of depression, and 74% of the high levels of emotional distress and 61% of the low levels. The most important variables in the fsQCA models were symptomatology, self-esteem, and parental styles. CONCLUSION: The patient's family dynamics, self-esteem, and emotional difficulties were the most relevant factors in predicting adjustment.

Psycho-emotional adjustment in parents of adolescents: A cross-sectional and longitudinal analysis of the impact of the COVID pandemic.

PURPOSE: adolescence is a time of change and it generally entails a greater family vulnerability thus; the aim of this study was to identify the risk factors for poor emotional adjustment to COVID among parents of adolescents. DESIGN AND METHODS: 94 parents of adolescents (11-18 years old, M = 13.90, SD = 1.85) participated at different times during the state of alert in Spain. 91.5% were mothers. Their ages ranged from 35 to 63 years (M = 46.54; SD = 5.09). The variables assessed were anxiety, depression and stress (DASS), moods (MOOD), somatization (SCL) and resilience (CD-RISC). Descriptive analyses, t-tests, ANOVAs, correlations, and hierarchical regressions were performed. All this by means of a cross-sectional and longitudinal study design. RESULTS: at the beginning of the confinement parents showed low levels of emotional distress and moderate levels of positive emotionality and resilience. However, those with a prior psychological problem, who had lost their job, or had lost someone to the pandemic, showed worse emotional adjustment. Resilience was relevant in predicting anxiety-depressive symptoms, and a low level of happiness was relevant in predicting stress. Emotional symptoms improved over time, and resilience remained stable. CONCLUSIONS: the emotional impact of COVID over time is influenced by mood, mental health, and resilience. In addition, parents who had a previous health problem, had lost their job or a loved one, had a worse adjustment. PRACTICAL IMPLICATIONS: it is important to carry out intervention programs that increase resilience, treating parents who require it, since their emotional adjustment has repercussions on the emotional adjustment of family system.

Is mHealth a useful therapy for improving physical or emotional health in adolescents with cystic fibrosis? A systematic review.

Cystic fibrosis (CF) is a rare disease that severely compromises health and interferes with the lives of those who suffer from it and is especially challenging in adolescence. The use of tools such as MHealth may benefit the physical and psychological health of adolescents with CF. Therefore, this study aims to examine the benefits of MHealth in adolescents with CF through a systematic review. A search of the scientific literature following the PRISMA guidelines was conducted in the ProQuest Central, PubMed, Web Of Science, Embase and ínDICE databases, resulting in 186 studies, of which seven were selected (based on inclusion and exclusion criteria). Two blinded evaluators conducted the searches, the selection and data extraction process and the quality evaluation of the studies. The agreement between evaluators was excellent in all cases (Kappa ranged from .78 to .96). 214 pediatric CF patients (61.71% female) participated in the final analysis. The mean age was 12.76 years. The studies evaluated different types of mHealth tools, with greater homogeneity in the independent and dependent variables. The quality of the studies analyzed was poor, since these had small samples selected for convenience, conducted non-experimental and low-quality designs, recorded few variables, and their statistical analyses were not sufficiently robust. Further research is needed in this field, improving research designs and considering physical and psychological adjustment variables, as well as patients and family members in the process of health improvement.

Relationships between affective states and childhood internalizing disorders.

Internalizing disorders are mainly defined as psychosomatic, anxiety and depression problems. The aim of this study was to analyze the relationships between dairy affective states and internalizing disorders in early adolescence (10-12 years old), considering the influence of sex. The participants of the study were 367 children aged between 10 and 12 (190 girls and 177 boys). The results showed that fear was the best predictor for all internalizing disorders, and the only common predictor for all of them. The prediction of boys' internalizing disorders was based only in fear, whereas the prediction for girls involved more variables besides fear. An early detection/regulation of these affective states (particularly fear) may be useful for the prevention and treatment of child internalizing disorders.

Is bronchial asthma a risk factor for emotional well-being in adolescence? A comparative study.

OBJECTIVE: This study aimed to investigate whether bronchial asthma could be a risk factor for emotional well-being during adolescence. METHODS AND MEASURES: This is a comparative cross-sectional design. A total of 450 participants aged 12 to 16 years (M = 13.61 and SD = 1.84) were included (150 with bronchial asthma and 300 healthy). For both groups, self-esteem, emotional distress, problems with peers, family styles and psychosocial bonds were assessed. T-tests and multi-group structural equation modelling were used for comparative analyses, and the moderating role was analysed through PROCESS. RESULTS: The t-tests showed a difference in means between the groups, finding lower self-esteem scores in adolescents with asthma, but better emotional well-being, a greater number of bonds and healthier family styles than those of their healthy peers. In the multi-group, the moderating role of bronchial asthma on emotional well-being in adolescence could not be assessed. Moderation analyses indicated that asthma was a moderating variable for the relationship between self-esteem and emotional well-being in adolescence. CONCLUSIONS: Asthma can be a stressful event that makes emotional well-being difficult in the adolescent stage, but there seem to be other more influential factors such as perceived family style or self-esteem.

Psychological intervention in women victims of childhood sexual abuse: a randomized controlled clinical trial comparing EMDR psychotherapy and trauma-focused cognitive behavioral therapy.

Introduction: Childhood sexual abuse persists as a painful societal reality, necessitating responses from institutions and healthcare professionals to prevent and address its severe long-term consequences in victims. This study implements an intervention comprising two psychotherapeutic approaches recommended by the WHO and international clinical guidelines for addressing short-, medium-, and long-term posttraumatic symptomatology: Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and Eye Movement Desensitization and Reprocessing (EMDR). Both approaches are adapted from group formats for implementation in small online groups via Zoom. Methods: The impact of both therapeutic approaches on trauma improvement was assessed in a sample of 19 women who were victims of childhood sexual abuse through a Randomized Clinical Trial comparing EMDR Psychotherapy and Trauma-Focused Cognitive Behavioral Therapy after a baseline period. Intra and inter comparison were made using statistics appropriate to the sample. Results: Both therapeutic approaches significantly reduced symptomatology across various evaluated variables, suggesting their efficacy in improving the quality of life for these individuals. Following CBT-FT treatment, patients exhibited enhanced emotional regulation, reduced reexperiencing, and avoidance. The EMDR group, utilizing the G-TEP group protocol, significantly improved dissociation, along with other crucial clinical variables and the perception of quality of life. Discussion: Although the limitations of this study must be taken into account due to the size of the sample and the lack of long-term follow-up, the results align with existing scientific literature, underscoring the benefits of trauma-focused psychological treatments. The online group format appears promising for enhancing the accessibility of psychological treatment for these women. Furthermore, the differential outcomes of each treatment support recent research advocating for the inclusion of both approaches for individuals with trauma-related symptomatology. Ethics and dissemination: The study has been approved by the Ethics Committee of the Valencian International University (VIU) (Valencia, Spain) (Ref. CEID2021_07). The results will be submitted for publication in peer-reviewed journals and disseminated to the scientific community. Clinical trial registration: https://clinicaltrials.gov/ct2/show/NCT04813224, identifier NCT04813224.

Patient-reported assessment of compassion in Spanish: a systematic review.

Aims and objectives: This systematic review aims to: (1) explore which tools have been used in Spanish to measure compassion; (2) know which of these tools could be used to assess compassion in healthcare settings from the perspective of patients; (3) evaluate the quality of these patient-reported measures in Spanish contexts; and (4) determine which of these instruments would be best suited to be used in healthcare settings. Background: Compassion has been recognized as a fundamental dimension of quality healthcare. Methods: Several scientific databases were consulted for relevant records published up to December 16th, 2021. In accordance with PRISMA guidelines, 64 studies were included. Results and conclusions: while existing instruments, validated in Spanish, allow for the measurement of self-compassion or compassion to others, there are no valid and reliable measures currently available in Spanish to measure patient-reported compassion. Relevance to clinical practice: In order to ensure and promote compassion in the health care context, it is essential to have a valid and reliable tool to measure this construct in a patient-informed way, and this is currently not possible in the Spanish-speaking context because of the lack of such an instrument in Spanish.

Family styles and quality of life in adolescents with bronchial asthma: The important role of self-esteem and perceived threat of the disease.

OBJECTIVES: Analyze the relationship between family styles and quality of life (QoL) in adolescents with bronchial asthma and study the influence of self-esteem as a protective factor and threat perception as a risk factor. METHODS: Family styles, QoL, perceived threat of the disease, and self-esteem were assessed in a total of 150 adolescents diagnosed with bronchial asthma with ages ranging from 12 to 16 years (M = 13.28; SD = 1.29), 60.7% being male. Descriptive statistics and mean comparisons were conducted according to the level of self-esteem. Relationships between variables were also studied using Pearson's correlations, and finally, the mediating role of self-esteem and the perceived threat of the disease was assessed using PROCESS. RESULTS: Adolescents shown healthy family characteristics (high scores on affect and parental mood and low scores on psychological control) and high scores on QoL. Thirty-five percent of adolescents showed low self-esteem and a tendency to underestimate the disease. There are existing relationships between family styles and QoL; thus, healthy family characteristics (affection, parental mood, autonomy promotion) were positively associated with QoL, while psychological control was negatively associated with QoL. Disease threat and self-esteem mediated the relationship between family styles and adolescent QoL. Disease threat was negatively, and self-esteem was positively associated with QoL. CONCLUSIONS: Self-esteem and family support are protective factors for the well-being of adolescents with bronchial asthma; however, the high perceived threat of the disease can have negative consequences for the adolescent's health and negatively impact their QoL.

Personal and family factors for emotional distress in adolescents with chronic disease.

Introduction: Physical and psychological comorbidity is a challenge for public health, especially in the adolescent stage due to the difficulties of this age. The salutogenic perspective emphasizes general psychological resources such as self-esteem but also highlights the role of contextual factors such as family members in promoting health. From this perspective, the objective of this study was to analyze the joint influence of demographic factors (sex, age and type of chronic disease), personal factors (self-esteem and perception of threat of the disease) and family factors (affection and communication, psychological and behavioral control) of risk of emotional distress (anxiety-depressive symptoms) in chronically ill adolescents. Methods: The study is a cross-sectional design with 495 adolescents with chronic disease aged 12-16 years. In order to obtain the results, a linear methodology was used to compare means and perform regressions to predict belonging to the anxiety and depression typologies. Four typologies were constructed: typology I (high anxiety and depression scores); typology II (high anxiety and low depression scores); typology III (low anxiety and high depression scores) and typology IV (low anxiety and depression scores). Results: The results were consistent with the salutugenic theory. Potential mediating or moderating roles of age, sex, self-esteem, perceived threat and psychological and behavioral control marked the differences between the typologies. Discussion: This population could benefit from interventions focused on family flexibility.

Overburden in Caregivers of Chronically Ill Adolescents: A Comparative Study between Pulmonological and Endocrinological Diseases.

Chronic pediatric disease has a major impact on the life of a child and his or her family. In this sense, the figure of the main caregiver is relevant, who may present adjustment difficulties before the disease, accompanied by high levels of stress and emotional discomfort, which interfere with the adolescent's adjustment before the new situation. The aim of this research was to carry out a comparative study among caregivers of adolescents with various diseases, analyzing the risk and protective factors for the stress presented by this population. For this purpose, a sample of 406 main caregivers of adolescents with an endocrinological or pneumological disease from different hospitals in Valencia was used, where characteristics related to the disease, attachment, type of family, and emotional distress of these caregivers were considered. In general, the results show higher levels of stress in caregivers of adolescents with an endocrinological disease, specifically DM1, and found significant predictors of anxiety-depressive symptomatology, the need for approval, and several variables related to the disease. These data reveal the importance of providing comprehensive care to the family system, offering health skills to overcome diseases, and reinforcing the protective factors offered by the family system.