Validation of the Jefferson Scale of Patient Perception of Physician Empathy Spanish (Spain) Version in Primary Care.

BACKGROUND AND OBJECTIVES: Empathy is considered a prerequisite for a successful physician-patient relationship. The Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) is a regularly-used, patient-rated measure of physician empathy. The aim of this study is to translate and analyze the reliability and validity of the JSPPPE Spanish (Spain) version (Sp-JSPPPE) in primary care in order to use it with medical trainees. METHODS: After translation and back translation of the JSPPPE, 369 patients from 21 primary care physicians in Pamplona (Navarre, Spain) completed the Sp-JSPPPE, a sociodemographic questionnaire, the Spanish (Spain) Consultation and Relational Empathy Measure (Sp-CARE), and a question about overall satisfaction. We studied internal reliability (Cronbach's α and ordinal α), homogeneity (corrected item-total correlations), construct validity (confirmatory factor analysis [CFA]) and concurrent validity (Spearman's correlation) of Sp-JSPPPE. RESULTS: Cronbach's α and ordinal α were 0.870 and 0.919, respectively, for the Sp-JSPPPE, and all corrected item-total correlations exceeded the accepted cutoff of 0.30, demonstrating high internal reliability and homogeneity. CFA corroborated the one-factor structure proposed in the original version. The total score for the Sp-JSPPPE was significantly correlated with sp-CARE (Spearman's ϱ 0.651, P<.001) and with overall patient satisfaction (Spearman's ϱ 0.504, P<.001). CONCLUSIONS: The results support the reliability and validity of the Sp-JSPPPE in primary care. Sp-JSPPPE could be useful in empathy assessment of medical trainees, both graduate and postgraduate, in the Spanish context.

Reliability and validity of the Spanish (Spain) version of the consultation and relational empathy measure in primary care.

BACKGROUND: Empathy is an essential competence in the medical field. There are no validated patient-rated empathy measures in Spanish (Spain). The Consultation and Relational Empathy (CARE) measure is a widely used patient-rated measure of physician empathy. OBJECTIVE: To analyse the reliability and validity of the Spanish (Spain) version of the CARE measure in primary care. METHODS: After translation, back translation and pilot testing, a convenient sample of 369 patients recruited through 21 primary care physicians in five primary care centres in Pamplona (Navarre, Spain) completed the Spanish (Spain) CARE (Sp-CARE) measure. The number of 'does not apply' or blank responses was calculated to assess acceptability. We analysed internal reliability by means of Cronbach's alpha and ordinal alpha and homogeneity with corrected item-total correlations. The construct validity was examined by confirmatory factor analysis (CFA) and concurrent validity by Spearman's correlation. RESULTS: We observed high acceptability; only 37 (1%) responses were marked 'does not apply' and only 3 (0.08%) were left blank. Cronbach's alpha and ordinal alpha for the Sp-CARE measure were 0.953 and 0.970, respectively, and all corrected item-total correlations exceeded the accepted cut of 0.30, demonstrating high internal reliability and homogeneity. CFA corroborated the one-factor structure proposed in the original version. The Sp-CARE measure total score was significantly correlated with overall patient satisfaction (Spearman's rho 0.45, P < 0.001). CONCLUSION: The results support the reliability and validity of the Sp-CARE measure as a patient-rated empathy measure in the primary care setting.

Psychosocial Adjustment to Illness Scale in family caregivers of patients with Parkinson's Disease: Spanish validation study.

Psychosocial adjustment to a complex and disabling long-term condition like Parkinson´s disease is a complex, dynamic, cyclical and interactive process. Family caregivers, face multiple challenges that require a significant effort in terms of psychosocial adjustment, which must be considered by healthcare professionals in order to provide a holistic care. The patients' self-report version of the Psychosocial Adjustment to Illness Scale (PAIS-SR), which has been validated in Spain for use in Parkinson's disease, is designed to evaluate the psychosocial adjustment of patients. Our purpose was to validate the Spanish PAIS-SR version for caregivers of patients with Parkinson's disease. An open, national cross-sectional study with one point-in-time evaluation and retest was carried out in 450 family caregivers of patients with Parkinson's disease. Data were collected in Spain from April 2016 to September 2017. The psychometric analysis performed showed that the Spanish version of the PAIS-SR for caregivers presents adequate indicators of reliability, internal and external validity, and is structured according to the seven-domain model proposed by the author of the instrument.

Relationship Power Imbalance and Known Predictors of Intimate Partner Violence in Couples Planning to Get Married: A Baseline Analysis of the AMAR Cohort Study.

The increased interest on measuring violence in romantic relationships has led to the identification of some risk factors for intimate partner violence (IPV) in its different forms. Some of them are often present from the onset of the relationships. However, little attention has been paid to the engagement period. This might be, in part, due to the cognitive dissonance that hinders partners reporting intimate violence when they are planning their wedding. The purpose of our study is to test the association between the individual perception of relationship power imbalance (RPI)-a possible indirect measure of intimate violence-and known predictors of IPV. To test this hypothesis, a total of 254 premarital couples taking part in a dynamic prospective cohort study completed a questionnaire with questions about the perception of RPI and referred predictors of IPV. Results showed a positive correlation between the perception of RPI and known predictors of IPV. These findings suggest that RPI is a powerful indirect measure to detect situations that might imply a mild form of IPV and that could evolve into stronger presentations of violence later in marriage. Noticing the presence of RPI before marriage could encourage the prevention and development of personal and relational strategies to avoid the consolidation of violent dynamics within the marital relationship.

A Structural Equation Model of Achievement Emotions, Coping Strategies and Engagement-Burnout in Undergraduate Students: A Possible Underlying Mechanism in Facets of Perfectionism.

Achievement emotions that the university student experiences in the learning process can be significant in facilitating or interfering with learning. The present research looked for linear and predictive relations between university students' achievement emotions, coping strategies, and engagement-burnout, in three different learning situations (classroom, study time, and testing). Hypotheses were identified for a possible model that would analyze the two facets of perfectionism based on these relations. In the case of perfectionistic strivings, the test hypothesis was that positive emotions would predispose the use of problem-focused coping strategies and an emotional state of engagement; in the case of perfectionistic concerns, however, negative emotions would predispose the use of emotion-focused strategies and a state of burnout. A total of 654 university students participated in the study, using an online tool to complete validated questionnaires on the three study variables. All students provided informed consent and corresponding permissions. Given the ex-post facto linear design, the predictions could be verified for each situation by means of logistic regression analyses and Structural Equations Models (SEM). Empirical results lent support, in varying degree, to the proposed theoretical relations. The testing situation was of particular interest. We discuss implications for perfectionism research and for the practice of prevention, education and health care in the university setting.

Maresin 1 inhibits TNF-alpha-induced lipolysis and autophagy in 3T3-L1 adipocytes.

Obesity is associated with high levels of pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), which promotes inflammation in adipose tissue. The omega-3 PUFAs, and their derived lipid mediators, such as Maresin 1 (MaR1) have anti-inflammatory effects on adipose tissue. This study aimed to analyze if MaR1 may counteract alterations induced by TNF-α on lipolysis and autophagy in mature 3T3-L1 adipocytes. Our data revealed that MaR1 (1-100 nM) inhibited the TNF-α-induced glycerol release after 48 hr, which may be related to MaR1 ability of preventing the decrease in lipid droplet-coating protein perilipin and G0/G1 Switch 2 protein expression. MaR1 also reversed the decrease in total hormone sensitive lipase (total HSL), and the ratio of phosphoHSL at Ser-565/total HSL, while preventing the increased ratio of phosphoHSL at Ser-660/total HSL and phosphorylation of extracellular signal-regulated kinase 1/2 induced by TNF-α. Moreover, MaR1 counteracted the cytokine-induced decrease of p62 protein, a key autophagy indicator, and also prevented the induction of LC3II/LC3I, an important autophagosome formation marker. Current data suggest that MaR1 may ameliorate TNF-α-induced alterations on lipolysis and autophagy in adipocytes. This may also contribute to the beneficial actions of MaR1 on adipose tissue and insulin sensitivity in obesity.

Personality: a determinant in marital dissatisfaction in individuals with major depression and their couples.

INTRODUCTION: Prior research suggests that some factors account for the association between marital dissatisfaction and Major Depression. We examined whether personality determines the association between marital dissatisfaction and a First Episode of Major Depression (FEMD), and whether specific personality factors are linked to marital dissatisfaction depending on the outcome of the FEMD. METHODS: The Hamilton Rating Scale for Depression and the Dyadic Adjustment Scale were administered both at baseline (T1) and six months later (T2), at 6 outpatient settings. We counted on the participation of 59 married couples with one member fulfilling DSM-IV criteria for a FEMD, and a healthy partner. Depressed participants also completed the NEO Personality Inventory-Revised. RESULTS: Certain personality factors mediate the association of a FEMD and Marital Dissatisfaction. "Neuroticism" mediates the association both at T1 and T2. However, the relationship between personality factors and Marital Dissatisfaction depends on the outcome of the Episode. If it has remitted by T2, personality might not be associated with marital interaction. However, if depression persists, "openness" and "conscientiousness" are related to less marital dissatisfaction. CONCLUSION: The most important mediating personality factor between marital dissatisfaction and a First Episode of Major Depression is "neuroticism".