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Objectives: To explore speaking up behaviours, barriers to openly expressing patient safety concerns, and perceived psychological safety climate in the clinical setting in which healthcare trainees from Ibero-America were receiving their practical training. Methods: Cross-sectional survey of healthcare trainees from Colombia, Mexico, and Spain (N = 1,152). Before the field study, the Speaking Up About Patient Safety Questionnaire (SUPS-Q) was translated into Spanish and assessed for face validity. A confirmatory factor analysis was conducted to establish the construct validity of the instrument, and the reliability was assessed. The SUPS-Q was used to evaluate voice behaviours and the perceived psychological safety climate among Ibero-American trainees. Descriptive and frequency analyses, tests for contrasting means and proportions, and logistic regression analyses were performed. Results: Seven hundred and seventy-one trainees had experience in clinical settings. In the previous month, 88.3% had experienced patient safety concerns, and 68.9% had prevented a colleague from making an error. More than a third had remained silent in a risky situation. Perceiving concerns, being male or nursing student, and higher scores on the encouraging environment scale were associated with speaking up. Conclusion: Patient safety concerns were frequent among Ibero-American healthcare trainees and often silenced by personal and cultural barriers. Training in speaking up and fostering safe interprofessional spaces is crucial.
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Segurança do Paciente , Humanos , Estudos Transversais , Masculino , Feminino , Adulto , Inquéritos e Questionários , Espanha , México , Colômbia , Adulto Jovem , Reprodutibilidade dos Testes , Atitude do Pessoal de SaúdeRESUMO
Resumen Las enfermedades cardiovasculares y la depresión se consideran problemas de salud pública, la depresión es un factor de riesgo para pacientes con insuficiencia cardiaca (IC) por sus implicaciones clínicas. El objetivo de este estudio fue describir dos modalidades de intervenciones psicoterapéuticas en el abordaje de la depresión en pacientes con IC. Métodos de búsqueda: Se realizaron búsquedas en las bases especializadas MEDLINE, PubMed, PsycINFO, Web of Science, CINAHL y Cochrane Library de 2010 a 2020. Criterios de selección: Se seleccionaron los artículos por título y resumen, publicados en los últimos 10 años, escritos en castellano o inglés y se eliminaron los registros repetidos. Obtención de los datos: Tres autores recopilaron la información de los estudios que se documentan. Resultados principales: Se incluyeron 4 estudios clínicos con 911 pacientes, se realizaron en 4 países en los últimos 10 años y se implementaron diferentes métodos de intervenciones digitales y visitas domiciliarias, los efectos de estos tratamientos han sido estadísticamente significativos para reducir los puntajes de depresión autoinformada en pacientes con IC que recibieron la intervención psicoterapéutica en alguna de estas modalidades a comparación de aquellos pacientes que solo recibieron un tratamiento estándar. Conclusiones: Debido al número limitado de estudios y de los diferentes métodos de intervención no se identifica un tratamiento estándar de la depresión en IC en estos formatos de atención, por lo que se recomienda más investigación en este campo de estudio.
Abstract Cardiovascular disease and depression are considered public health problems, depression is a risk factor for patients with heart failure (HF) for its clinical implications. The objective of this study was to describe two modalities of psychotherapeutic interventions in the approach to depression in patients with HF. Search methods: We searched the specialized databases MEDLINE, PubMed, PsycINFO, Web of Science, CINAHL and Cochrane Library from 2010 to 2020. Selection criteria. Articles were selected by title and abstract., published in the last 10 years, written in Spanish or English and repeated registrations were deleted. Obtaining the data: Three authors collected information from the studies being documented. Main results: We included 4 clinical studies with 911 patients, were conducted in 4 countries in the last 10 years and implemented different methods of digital interventions and home visits, the effects of these treatments have been statistically significant to reduce self-reported depression scores in patients with HF who received psychotherapeutic intervention in any of these modalities compared to those patients who only received a treatment. Conclusions: Due to the limited number of studies and different methods of intervention, a standard treatment of HF depression in these care formats is not identified, so more research in this field of study is recommended.
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Abstract Background Fear of cancer recurrence is one of the most distressing psychological consequences in cancer survivors and their informal primary caregivers (IPC). IPC of childhood cancer survivors (CCS) are often their mothers, which could intensify fear of cancer recurrence (FCR) and its impact on both IPC and CCS. However, the phenomenon has not been widely described in this specific population. Objective To summarize and analyze current evidence on the evaluation and management of FCR among IPC of CCS. Method A narrative review of studies included in four databases (PsycInfo, Medline, CINALH, and Web of Science) with no language or year of publication restrictions. Results Measures specifically developed to assess FCR among IPC of CCS comprising an interview and a questionnaire with initial psychometric evaluations and two short, online intervention programs based on cognitive-behavioral-contextual therapy were identified (ENGAGE and CASCAdE). Both have demonstrated acceptability in parents of CCS in high-income countries; preliminary evidence also exists of the effectivity of CASCAdE in reducing FCR. Discussion and conclusion Given the limitations of this area of psychological evaluation, the Fear of Cancer Recurrence Inventory, originally developed for adult cancer survivors, constitutes the most suitable tool for evaluating FCR among IPC of CCS. The CASCAdE program seems a promising intervention for IPC of CSS, although cultural adaptations, evaluations of its acceptability in low- and middle-income countries, and controlled studies in large samples are still required.
Resumen Antecedentes El miedo a la recurrencia del cáncer es una de las consecuencias psicológicas más angustiantes en los supervivientes y sus cuidadores primarios informales (CPI). Los CPI de supervivientes de cáncer infantil (SCI) a menudo son sus madres, lo que podría intensificar el miedo a la recurrencia (MR) y su impacto tanto a los CPI como a los SCI. Sin embargo, el fenómeno no se ha descrito ampliamente en esta población específica. Objetivo Resumir y analizar la evidencia actual sobre la evaluación y manejo del MR entre CPI de SCI. Método Se realizó una revisión narrativa de los estudios incluidos en cuatro bases de datos (PsycInfo, Medline, CINALH y Web of Science) sin restricciones de idioma o año de publicación. Resultados Se identificaron instrumentos desarrollados específicamente para evaluar MR entre CPI de SCI que comprenden una entrevista y un cuestionario, además de dos programas de intervención en línea basados en terapia cognitivo-conductual-contextual (ENAGE y CASCAdE). Ambos demostraron aceptabilidad en los padres de SCI en países de ingresos altos. También existe evidencia preliminar de la efectividad de CASCAdE en la disminución del MR. Discusión y conclusión Dadas las limitaciones de esta área de evaluación psicológica, el Inventario del Miedo a la Recurrencia del Cáncer, desarrollado originalmente para supervivientes adultos, constituye la herramienta más adecuada para evaluar MR en los CPI de SCI. El programa CASCAdE parece una intervención prometedora para CPI de SCI, aunque aún requiere adaptaciones culturales, evaluaciones de aceptabilidad en países de ingresos medio-bajos y estudios controlados con nuestras más grandes.
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Abstract: Cardiovascular disease and depression are considered public health problems, depression is a risk factor for patients with heart failure (HF) for its clinical implications. The objective of this study was to describe two modalities of psychotherapeutic interventions in the approach to depression in patients with HF. Search methods: We searched the specialized databases MEDLINE, PubMed, PsycINFO, Web of Science, CINAHL and Cochrane Library from 2010 to 2020. Selection criteria. Articles were selected by title and abstract., published in the last 10 years, written in Spanish or English and repeated registrations were deleted. Obtaining the data: Three authors collected information from the studies being documented. Main results: We included 4 clinical studies with 911 patients, were conducted in 4 countries in the last 10 years and implemented different methods of digital interventions and home visits, the effects of these treatments have been statistically significant to reduce self-reported depression scores in patients with HF who received psychotherapeutic intervention in any of these modalities compared to those patients who only received a treatment. Conclusions: Due to the limited number of studies and different methods of intervention, a standard treatment of HF depression in these care formats is not identified, so more research in this field of study is recommended.
Resumen: Las enfermedades cardiovasculares y la depresión se consideran problemas de salud pública, la depresión es un factor de riesgo para pacientes con insuficiencia cardiaca (IC) por sus implicaciones clínicas. El objetivo de este estudio fue describir dos modalidades de intervenciones psicoterapéuticas en el abordaje de la depresión en pacientes con IC. Métodos de búsqueda: Se realizaron búsquedas en las bases especializadas MEDLINE, PubMed, PsycINFO, Web of Science, CINAHL y Cochrane Library de 2010 a 2020. Criterios de selección: Se seleccionaron los artículos por título y resumen, publicados en los últimos 10 años, escritos en castellano o inglés y se eliminaron los registros repetidos. Obtención de los datos: Tres autores recopilaron la información de los estudios que se documentan. Resultados principales: Se incluyeron 4 estudios clínicos con 911 pacientes, se realizaron en 4 países en los últimos 10 años y se implementaron diferentes métodos de intervenciones digitales y visitas domiciliarias, los efectos de estos tratamientos han sido estadísticamente significativos para reducir los puntajes de depresión autoinformada en pacientes con IC que recibieron la intervención psicoterapéutica en alguna de estas modalidades a comparación de aquellos pacientes que solo recibieron un tratamiento estándar. Conclusiones: Debido al número limitado de estudios y de los diferentes métodos de intervención no se identifica un tratamiento estándar de la depresión en IC en estos formatos de atención, por lo que se recomienda más investigación en este campo de estudio.
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Depressão , Insuficiência Cardíaca , Humanos , Depressão/terapia , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/terapia , Intervenção PsicossocialRESUMO
Background: Scientific research has reported various stressors that could be related to the development of burnout in resident physicians. Objective: To identify the perceived stressors associated with burnout in residents of various medical specialties in Mexico's northwest. Material and methods: A cross-sectional, explanatory, observational, and analytical study was carried out. The sampling was non-probabilistic. Resident physicians from two hospitals in southern Sonora participated. The Occupational Burnout Scale (OED) and the Stressors Check List with intensity were used. Results: 189 resident physicians were included. 87% presented high levels of burnout. Specifically, the work overload and job dissatisfaction stressors were the ones with the greatest predictive power of burnout and dissatisfaction with achievement in resident physicians. By dimensions, physical problems were predictors of the pain dimension in the occupational burnout state. Professional exercise and physical problems predicted burnout in occupational burnout state. And physical problems were predictors for the presence of depression. Conclusions: The data obtained confirm the need to attend physical and mental health of resident doctors, and promote optimal work environments that have a positive impact on the well-being of their members.
Introducción: la investigación científica ha reportado diversos estresores que podrían estar relacionados con el desarrollo del burnout en médicos residentes. Objetivo: identificar los estresores percibidos asociados con burnout en residentes de diversas especialidades médicas en el noroeste de México. Material y métodos: se realizó un estudio analítico, observacional, explicativo y transversal. El muestreo fue no probabilístico. Participaron médicos residentes de dos hospitales del sur de Sonora. Se utilizó la Escala de desgaste ocupacional (EDO) y la Lista de chequeo de estresores con intensidad. Resultados: se incluyeron 189 médicos residentes. El 87% presentó altos niveles de burnout. Específicamente los estresores sobrecarga laboral e insatisfacción laboral tuvieron mayor poder predictivo del agotamiento y la insatisfacción de logro en los médicos residentes. Por dimensiones, los problemas físicos fueron predictores de la dimensión de dolor en el estado de desgaste ocupacional. Asimismo, el ejercicio profesional y los problemas físicos predijeron el agotamiento en el estado de desgaste ocupacional. Y los problemas físicos fueron predictores para la presencia de depresión. Conclusiones: los datos obtenidos confirman la necesidad de atender la salud física y mental de los médicos residentes, así como promover ambientes laborales óptimos que tengan un impacto positivo en el bienestar de sus integrantes.
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Esgotamento Profissional , Medicina , Médicos , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/etiologia , Esgotamento Profissional/psicologia , Esgotamento Psicológico , Estudos Transversais , Humanos , Médicos/psicologiaRESUMO
Introducción: la investigación científica ha reportado diversos estresores que podrían estar relacionados con el desarrollo del burnout en médicos residentes. Objetivo: identificar los estresores percibidos asociados con burnout en residentes de diversas especialidades médicas en el noroeste de México. Material y métodos: se realizó un estudio analítico, observacional, explicativo y transversal. El muestreo fue no probabilístico. Participaron médicos residentes de dos hospitales del sur de Sonora. Se utilizó la Escala de desgaste ocupacional (EDO) y la Lista de chequeo de estresores con intensidad. Resultados: se incluyeron 189 médicos residentes. El 87% presentó altos niveles de burnout. Específicamente los estresores sobrecarga laboral e insatisfacción laboral tuvieron mayor poder predictivo del agotamiento y la insatisfacción de logro en los médicos residentes. Por dimensiones, los problemas físicos fueron predictores de la dimensión de dolor en el estado de desgaste ocupacional. Asimismo, el ejercicio profesional y los problemas físicos predijeron el agotamiento en el estado de desgaste ocupacional. Y los problemas físicos fueron predictores para la presencia de depresión. Conclusiones: los datos obtenidos confirman la necesidad de atender la salud física y mental de los médicos residentes, así como promover ambientes laborales óptimos que tengan un impacto positivo en el bienestar de sus integrantes
Background: Scientific research has reported various stressors that could be related to the development of burnout in resident physicians. Objective: To identify the perceived stressors associated with burnout in residents of various medical specialties in Mexico's northwest. Material and methods: A cross-sectional, explanatory, observational, and analytical study was carried out. The sampling was non-probabilistic. Resident physicians from two hospitals in southern Sonora participated. The Occupational Burnout Scale (OED) and the Stressors Check List with intensity were used. Results: 189 resident physicians were included. 87% presented high levels of burnout. Specifically, the work overload and job dissatisfaction stressors were the ones with the greatest predictive power of burnout and dissatisfaction with achievement in resident physicians. By dimensions, physical problems were predictors of the pain dimension in the occupational burnout state. Professional exercise and physical problems predicted burnout in occupational burnout state. And physical problems were predictors for the presence of depression. Conclusions: The data obtained confirm the need to attend physical and mental health of resident doctors, and promote optimal work environments that have a positive impact on the well-being of their members
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Humanos , Adulto , Estudantes de Medicina , Esgotamento Profissional , Estudos Transversais , Esgotamento Psicológico , Estresse Psicológico , Saúde Mental , Saúde Ocupacional , MéxicoRESUMO
Abstract Communicating bad news is one of the most frequent activities in hospitals, for which some recommendations have been adapted to the needs within the coronavirus-2 disease (COVID-19) context. This document presents nine steps to deliver bad news (face to face or remotely) adapted to the COVID-19 context from two international protocols (SPIKES and GRIEV_ING). The importance of promoting physical and emotional self-care skills in health personnel is also described, as well as psychological first aid strategies to address the emotional response of the family member who receives the news. Finally, the limitations and advantages of the proposal should be considered.
Resumen La comunicación de malas noticias es una de las actividades más frecuentes en los hospitales dentro del contexto de la COVID-19. A pesar de su alta frecuencia, existen pocas recomendaciones adaptadas a las necesidades que el contexto de la COVID-19 demanda. Debido a lo anterior, en el presente escrito se presentan nueve pasos para dar malas noticias (cara a cara o por vía remota) de dos protocolos internacionales (SPIKES y GRIEV_ING) adaptados a las necesidades de transmisión de información de la COVID-19. Se describe también la importancia de promover habilidades de autocuidado físico y emocional en el personal de salud, así como estrategias de primeros auxilios psicológicos para el abordaje de la respuesta emocional del familiar que recibe la noticia. Finalmente, se deben considerar las limitaciones y ventajas de la propuesta.
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Infecções por Coronavirus , Pandemias , Pneumonia Viral , Telemedicina , Betacoronavirus , COVID-19 , SARS-CoV-2Assuntos
Pneumonia Viral , Telemedicina , Infecções por Coronavirus , Pandemias , Betacoronavirus , SARS-CoV-2 , COVID-19RESUMO
It is estimated that more than 300,000 people have died because of COVID-19 globally. The vast majority of documented deaths have occurred within hospitals, leading to psychological impacts on both family members and health care workers. This paper describes the actions (online death notification education, remote crisis intervention, and support for health care professionals) taken at a hospital in Mexico to address the psychological impacts of the notification of a COVID-19-related death on both the deceased's relatives and the health care personnel involved. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Infecções por Coronavirus , Intervenção em Crise , Morte , Família , Serviços de Saúde Mental , Pandemias , Recursos Humanos em Hospital , Pneumonia Viral , Relações Profissional-Família , Apoio Social , Telemedicina , COVID-19 , Humanos , México , Recursos Humanos em Hospital/educação , Recursos Humanos em Hospital/psicologiaRESUMO
Communicating bad news is one of the most frequent activities in hospitals, for which some recommendations have been adapted to the needs within the coronavirus-2 disease (COVID-19) context. This document presents nine steps to deliver bad news (face to face or remotely) adapted to the COVID-19 context from two international protocols (SPIKES and GRIEV_ING). The importance of promoting physical and emotional self-care skills in health personnel is also described, as well as psychological first aid strategies to address the emotional response of the family member who receives the news. Finally, the limitations and advantages of the proposal should be considered.
La comunicación de malas noticias es una de las actividades más frecuentes en los hospitales dentro del contexto de la COVID-19. A pesar de su alta frecuencia, existen pocas recomendaciones adaptadas a las necesidades que el contexto de la COVID-19 demanda. Debido a lo anterior, en el presente escrito se presentan nueve pasos para dar malas noticias (cara a cara o por vía remota) de dos protocolos internacionales (SPIKES y GRIEV_ING) adaptados a las necesidades de transmisión de información de la COVID-19. Se describe también la importancia de promover habilidades de autocuidado físico y emocional en el personal de salud, así como estrategias de primeros auxilios psicológicos para el abordaje de la respuesta emocional del familiar que recibe la noticia. Finalmente, se deben considerar las limitaciones y ventajas de la propuesta.
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COVID-19 , Família/psicologia , Autocuidado/psicologia , Revelação da Verdade , Comunicação , Pessoal de Saúde/organização & administração , Humanos , InternacionalidadeRESUMO
The purpose of this study was to assess the effect of tailored cognitive behavioral therapy (CBT) on depression and anxiety symptoms present in Mexican terminal cancer patients. A non-concurrent multiple baseline design was used across individuals. Nine patients participated in the study, each receiving four to six therapy sessions. The effect size of the intervention range (NAP and Tau indexes) in the nine patients indicates that CBT intervention resulted in weak to moderate impact for anxiety and depression symptoms in this population. The overall standardized mean difference is also moderate, with a reduction of 0.54 and 0.76 standard deviations in depression and anxiety symptoms, respectively. This study provides initial evidence to support a positive effect from CBT on patients with terminal cancer and with mood disorders when facing their impending death.
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Ansiedade/complicações , Ansiedade/terapia , Terapia Cognitivo-Comportamental/métodos , Depressão/complicações , Depressão/terapia , Neoplasias/complicações , Assistência Terminal/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/psicologia , Depressão/psicologia , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Neoplasias/psicologia , Resultado do TratamentoRESUMO
INTRODUCTION: Stress is a variable that may play an important role in the development of obesity and in the quality of life of patients who are candidates for bariatric surgery, since stress is linked to the consumption of hypercaloric foods, sedentariness and higher incidence of psychological disorders. OBJECTIVE: To describe the most common types of stress coping strategies in patients who are candidates for bariatric surgery and establish their relationship with body mass index and quality of life perception. METHOD: One-hundred and one patients with severe obesity who were candidates for bariatric surgery were evaluated by means of the Stress Coping Questionnaire and the Quality of Life and Health Inventory. RESULTS: The most commonly used coping type is action and the most common strategy is focus on problem solving. Five coping strategies were significantly associated with quality of life; there was no significant association with body mass index. CONCLUSION: There is an association between some coping styles and quality of life in individuals who are candidates for bariatric surgery.
INTRODUCCIÓN: El estrés es una variable que puede desempeñar un papel importante en el desarrollo de la obesidad y en la calidad de vida de los pacientes candidatos a cirugía bariátrica, ya que se vincula a la ingesta de alimentos hipercalóricos, sedentarismo y mayor incidencia de trastornos psicológicos. OBJETIVO: Describir el tipo y estrategias de afrontamiento al estrés más frecuentes en los pacientes candidatos a cirugía bariátrica y establecer su relación con el índice de masa corporal y su percepción de calidad de vida. MÉTODO: Se evaluaron 101 pacientes con obesidad severa candidatos a cirugía bariátrica por medio del Cuestionario de Afrontamiento al Estrés y el Inventario de Calidad de Vida y Salud. RESULTADOS: El tipo de afrontamiento más utilizado es la acción y la estrategia más frecuente es la focalización en solución de problemas. Cinco estrategias de afrontamiento se asociaron significativamente con la calidad de vida; no hubo asociación significativa con el índice de masa corporal. CONCLUSIÓN: Existe asociación entre algunos estilos de afrontamiento y la calidad de vida de los individuos candidatos a cirugía bariátrica.
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Cirurgia Bariátrica/métodos , Obesidade/psicologia , Qualidade de Vida , Estresse Psicológico/epidemiologia , Adaptação Psicológica , Adolescente , Adulto , Idoso , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/cirurgia , Inquéritos e Questionários , Adulto JovemRESUMO
The aim of this paper is to describe educational programs that reportedly teach how to break bad news in the emergency department. We also suggest some recommendations on how to communicate bad news based on the research of evidence available in the field. The examined evidence points toward six major components with which physicians should familiarize when communicating bad news: 1) doctor-patient empathic communication, 2) establishing a proper space to give the news, 3) identifying characteristics of the person who receives the news, 4) essential aspects for communicating the news; 5) emotional support, and 6) medical and administrative aspects of the encounter. Finally, we point out several limitations in the studies in the field and future challenges identified in the communication of bad news in emergency room facilities.
El objetivo del presente trabajo es reseñar una descripción de los programas educativos que incluyen el entrenamiento de la comunicación de malas noticias a médicos pertenecientes al departamento de urgencias. Además se hacen recomendaciones sobre cómo dar malas noticias con base en la evidencia de investigación hasta ahora disponible en las áreas de urgencias. De acuerdo con la información obtenida, es factible identificar seis grandes áreas con las que el médico requiere familiarizase cuando comunica malas noti cias: 1) comunicación empática médico-paciente, 2) preparación del ambiente para dar la noticia, 3) identificación de las características de quien recibe la noticia, 4) aspectos indispensables al comunicar la noticia, 5) manejo de reacciones emocionales y 6) aspectos médicos, administrativos y del cierre del encuentro. Finalmente, se describen las limitaciones que parecen caracterizar a los estudios en el área y se señalan los retos futuros en la comunicación de malas noticias en urgencias médicas.
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Serviço Hospitalar de Emergência , Relações Médico-Paciente , Relações Profissional-Família , Revelação da Verdade , Competência Clínica , Empatia , Humanos , Apoio SocialRESUMO
La depresión es uno de los problemas emocionales más frecuentes en pacientes con cáncer terminal. Debido a la evolución de la enfermedad, varios síntomas físicos presentes en los pacientes se pueden yuxtaponer y confundir con los síntomas que permiten identificar de manera taxonómica la depresión, lo cual dificulta la evaluación del problema. El objetivo de este artículo es realizar una revisión de los principales instrumentos utilizados para evaluar la depresión en pacientes con cáncer terminal, junto con sus implicaciones en el contexto mexicano. Con base en la información recabada se puede decir que es más pertinente realizar una evaluación de la depresión enfocada en los aspectos emocionales que en los somáticos. Actualmente existe una gran cantidad de instrumentos para evaluar la depresión que dan mayor énfasis a los aspectos de la anhedonia y las emociones que a los aspectos somáticos de la depresión. En México existe un enorme rezago en el desarrollo de instrumentos que permitan identificar estos síntomas. Se concluye señalando instrumentos alternativos para evaluar la depresión en pacientes con cáncer terminal, estos instrumentos podrían ser evaluados y considerados en un futuro en el contexto de la medicina paliativa.
Depression is one of the most common emotional problems in palliative patients. Due to the advanced nature of the disease, several physical symptoms presented by patients overlap with symptoms of depression, making it difficult to evaluate and diagnose the problem. The aim of this paper was to conduct a narrative review of the main instruments used to assess depression when it is present in palliative patients, with a special consideration of the Mexican context. Based on the available data and the scholarly literature, it is more appropriate to conduct an assessment of depression focused on emotional aspects than somatics aspects in palliative patients. Internationally, a number of depression assessments place greater emphasis on anhedonia and emotions, such as hopelessness, than on somatic aspects of depression. In Mexico, a considerable gap remains in the development of instruments to identify depression in the palliative setting. Finally, we describe alternative assessments of depression, which could be evaluated and considered in the future in the palliative care setting.
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This case report describes a 24-year-old man diagnosed with multiple endocrine neoplasia type IIB and major depression. Because cognitive behavioural therapy (CBT) has proven effective in the treatment of major depression in the general population and patients with cancer, we decided to adapt and use this therapy and evaluate its impact on major depression and the patient's quality of life. The therapy was conducted individually in 15 sessions that were given over a span of 25â weeks. The data show that therapy was a useful treatment that reduced depression according to the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria and self-report instruments. CBT also helped improve the patient's quality of life, and it was considered to be an acceptable intervention for the patient, with ongoing positive results 1â year after the last psychotherapy session. CBT is a potential option for treating depression in this population but further research is needed.