Psychometric properties of the Depression Anxiety Stress Scales (DASS-21) in women with breast cancer.

Breast cancer impacts the psychological well-being of women, leaving them at risk of developing depression, anxiety, and other stress-related disorders. The Depression Anxiety Stress Scales (DASS-21) is a widely used measure, although empirical evidence regarding its psychometric properties in the breast cancer population is limited. The purpose of this study was to conduct an exhaustive analysis of the psychometric properties of the DASS-21 in a sample of Spanish women diagnosed with breast cancer. Participants were 289 breast cancer patients who completed the DASS-21 and other questionnaires measuring life satisfaction, positive and negative affect, flourishing, perceived stress, and breast cancer-specific stressors. In terms of validity evidence based on the internal structure of the DASS-21, adequate fit indices were obtained for the model based on three first-order factors (depression, anxiety, stress) and one second-order factor (general psychological distress). Reliability coefficients (McDonald's omega) ranged from .84 to .95. Validity evidence based on relationships with other variables was also provided by moderate and strong correlations with well-being indicators and stress measures. The results support the use of the DASS-21 for measuring general psychological distress in the breast cancer context, where it may provide useful information for the design of psychological interventions with patients.

Co-Microencapsulation of Cushuro (Nostoc sphaericum) Polysaccharide with Sacha Inchi Oil (Plukenetia huayllabambana) and Natural Antioxidant Extracts.

Cushuro (Nostoc sphaericum) polysaccharide was used to co-microencapsulate sacha inchi oil, natural antioxidant extracts from the oleoresin of charapita chili peppers (Capsicum frutescens L.) and grape orujo (Vitis vinifera L.). Encapsulation efficiency, moisture, particle size, morphology, oxidative stability, shelf-life, solubility, essential fatty acid profile, sterol content and antioxidant capacity were evaluated. The formulations with grape orujo extract showed higher oxidative stability (4908 ± 184 h), antioxidant capacity (4835.33 ± 40.02 µg Trolox/g ms), higher phenolic contents (960.11 ± 53.59 µg AGE/g ms) and a smaller particle size (7.55 µm) than the other formulations, as well as good solubility and a low moisture content. Therefore, grape orujo extracts can be used as natural antioxidants. The fatty acid composition (ω-3) remained quite stable in all the formulations carried out, which also occurred for sterols and tocopherols. In combination with gum arabic, grape orujo extract offered oxidative protection to sacha inchi oil during the first week of storage.

The Flourishing Scale: Psychometric Properties in Breast Cancer Patients.

BACKGROUND/OBJECTIVE: Promoting well-being is a key goal of cancer care, and it needs to be assessed using appropriate instruments. Flourishing is considered part of psychological well-being and it is commonly assessed with the Flourishing Scale (FS). To our knowledge, no studies have analyzed the psychometric properties of the FS in breast cancer patients. Our aim here was to provide validity evidence for use of the FS in this context. METHOD: Participants were 217 Spanish women with breast cancer who completed the FS and other scales assessing positive psychology constructs (life satisfaction, positive affect, resilience, self-esteem, optimism) and indicators of psychological maladjustment (negative affect, depression, anxiety, and stress). The internal structure of the FS was analyzed using confirmatory factor analysis (CFA). We calculated the average variance extracted (AVE) to evaluate convergent validity, and both McDonald's omega and Cronbach's alpha coefficients to estimate reliability. Item analysis was performed by computing corrected item-total correlations. Validity evidence based on relationships with other variables was obtained through Pearson correlation analysis, controlling for age and cancer stage. RESULTS: The CFA supported a single-factor structure, with adequate goodness-of-fit indices (CFI = 0.997, NNFI = 0.996, RMSEA = 0.069, and SRMR = 0.047) and standardized factor loadings ranging from 0.70 to 0.87. The value of the AVE was 0.63, and the reliability coefficient obtained with both procedures was 0.91. Corrected item-total correlations ranged from .62 to .78. Correlation analysis showed direct and strong associations between the FS score and scores on positive psychology constructs (range from 0.43 to 0.74), the strongest correlations being with positive affect and life satisfaction. The FS score was inversely correlated with scores on depression, anxiety, stress, negative affect, and pessimism (range from -0.14 to -0.52), the strongest association being with stress. DISCUSSION: The FS is a useful tool for exploring well-being in the breast cancer context, providing useful information for psychological assessment.

Co-Microencapsulation of Sacha Inchi (Plukenetia huayllabambana) Oil with Natural Antioxidants Extracts.

Sacha inchi (Plukenetia huayllabambana) oil was co-microencapsulated with natural antioxidant extracts (NAE), such as camu-camu (Myrciaria dubia (HBK) Mc Vaugh) fruit, Añil variety Andean potato (Solanum tuberosum andigenum, and elderberry fruit (Sambucus peruviana). Gum Arabic and the ternary combination of gum Arabic (GA) + maltodextrin (MD) + whey protein isolate (WPI) at different formulations were used as coating materials for the encapsulation process using spray-drying. The moisture content, particle size distribution and morphology, total phenolic content, antioxidant activity, fatty acid and sterol composition, oxidative stability, and shelf-life were evaluated. Co-microcapsules of sacha inchi (P. huayllabambana) oil with camu camu skin extract (CCSE) at 200 ppm encapsulated with GA + MD + WPI had the highest total polyphenol content (4239.80 µg GAE/g powder), antioxidant activity (12,454.00 µg trolox/g powder), omega-3 content (56.03%), ß-sitosterol (62.5%), greater oxidative stability (Oxidation Onset temperature of 189 °C), higher shelf-life (3116 h), and smaller particle sizes (6.42 µm). This research enhances the knowledge to obtain microcapsules containing sacha inchi (P. huayllabambana) oil with natural antioxidant extracts that could be used for the development of functional foods. Further research is needed to study the potential interactions and their influence between the bioactive components of the microcapsules and the challenges that may occur during scale-up to industrial production.

Psychometric properties of the perceived stress scale (pss-10) with breast cancer patients.

Breast cancer diagnosis is one of the most difficult events that a woman can experience during her life and it usually produces high levels of stress. Global measures of perceived stress are useful for screening and for comparing stress levels between cancer patients and other clinical and nonclinical populations. One such instrument that is widely used is the Perceived Stress Scale (pss-10), but its psychometric properties have scarcely been analysed with breast cancer patients. The aim of this study was to provide validity evidence regarding the use of the 10-item version of the pss-10 as a tool for measuring perceived stress in this context. Participants were 215 Spanish breast cancer patients who completed the PSS-10 and the DASS-21, a measure of affective distress (depression, anxiety, and stress). The internal structure of the PSS-10 was examined through confirmatory factor analysis (CFA), and the reliability of test scores was estimated using McDonald's omega coefficient. Validity evidence based on relationships with other variables was also obtained using correlation analysis. The CFA supported a correlated two-factor structure: perceived helplessness (six negatively worded items) and perceived self-efficacy (four positively worded items). Reliability coefficients for scores on these two factors were 0.87 and 0.73, respectively. Scores on affective distress (DASS-21) were strongly and positively correlated with perceived helplessness and moderately and negatively correlated with perceived self-efficacy. The PSS-10 is an adequate tool for measuring perceived stress in the breast cancer context and it may be useful for identifying women at risk of psychological maladjustment.

Design of Functional Powdered Beverages Containing Co-Microcapsules of Sacha Inchi P. huayllabambana Oil and Antioxidant Extracts of Camu Camu and Mango Skins.

Sacha inchi Plukenetia huayllabambana oil (SIPHO) was co-microencapsulated, by spray drying using gum arabic as a coating material, with antioxidant extracts of camu camu (Myrciaria dubia (HBK) McVaugh) (CCSE) and mango (Mangifera indica) (MSE) skins obtained by ultrasound-microwave-assisted extraction (UMAE). The physicochemical characteristics of the microcapsules, such as, particle size, morphology, and moisture, as well as the encapsulation efficiency, the fatty acid composition, and oxidative stability, were determined in order to select the best formulation for the design of functional powdered beverages. The formulation with the highest amounts of ω3 acids and polyphenols was used to prepare a functional powdered beverage that contained ω3 (52.74%), antioxidant activity (324.80 mg AAE/100 g powder), and acceptable sensory attributes.

The Satisfaction with Life Scale in breast cancer patients: Psychometric properties.

BACKGROUND/OBJECTIVE: This study aims to analyze the psychometric properties of the Satisfaction with Life Scale (SWLS), examining the reliability of scale scores and providing validity evidence for its use with breast cancer patients. We provide validity evidence based on internal structure and on relationships with positive psychological variables and other variables indicative of psychological adjustment. METHOD: Participants were 222 Spanish women with a diagnosis of breast cancer. They completed the SWLS and a battery of questionnaires measuring positive and negative affect, self-esteem, resilience, emotional intelligence, flourishing, optimism, depression, anxiety, and stress. RESULTS: Confirmatory factor analysis supported a single-factor structure for the SWLS, S-B χ2 (5) = 7.36, p = .19, CFI = .99, NNFI = .99, RMSEA = .046. The reliability of test scores estimated with McDonald's omega yielded a value of .80. Validity evidence was provided by a positive correlation between SWLS scores and positive affect, self-esteem, resilience, emotional intelligence (specifically, clarity and repair), flourishing, and optimism (range: .24, .69), and by a negative correlation with negative affect, pessimism, depression, anxiety, and stress (range: -.25, -.59). CONCLUSIONS: The Spanish version of the SWLS showed satisfactory psychometric properties and it is an appropriate measure for use in the breast cancer context.

ANTECEDENTES/OBJETIVO: El objetivo deestudio es examinar las propiedades psicométricas de la Escala de Satisfacción con la Vida (SWLS), analizando la fiabilidad de sus puntuaciones y aportando evidencias para su uso en pacientes con cáncer de mama. Se proporcionan evidencias de validez basadas en la estructura interna y en la relación con otras variables psicológicas positivas y con otras indicativas de ajuste psicológico. MÉTODO: Han participado 222 mujeres españolas diagnosticadas de cáncer de mama, que cumplimentaron la SWLS y medidas de afecto positivo y negativo, autoestima, resiliencia, inteligencia emocional, florecimiento, optimismo, depresión, ansiedad y estrés. RESULTADOS: El análisis factorial confirmatorio indicó una estructura unidimensional, S-B χ2(5) = 7,36, p = 0,19, CFI = 0,99, NNFI = 0,99, RMSEA = 0,046. La fiabilidad de las puntuaciones estimadas con omega de McDonald fue de 0,80. Las evidencias de validez mostraron correlaciones positivas entre las puntuaciones de SWLS y afecto positivo, autoestima, inteligencia emocional (específicamente, claridad y reparación), florecimiento y optimismo (rango 0,24 0,69), así como correlaciones negativas con afecto negativo, pesimismo, depresión, ansiedad, y estrés (rango -0,25 - 0,59). CONCLUSIONES: La versión española de la SWLS muestra adecuadas propiedades psicométricas, siendo una medida apropiada para utilizarla en pacientes de cáncer de mama.

Psychometric properties of the Connor-Davidson Resilience Scale in women with breast cancer.

The aim was to analyse the psychometric properties of the 10-item version of the Connor-Davidson Resilience Scale (CD-RISC 10©) in breast cancer patients. METHOD: A sample of 169 Spanish women who had undergone surgery for breast cancer completed the CD-RISC 10©, along with questionnaires assessing life satisfaction, emotional intelligence, self-esteem, and positive and negative affect. RESULTS: Confirmatory Factor Analysis supported a single-factor structure with adequate fit indices. Reliability was analysed by calculating McDonald's omega coefficient, which yielded a value of .83. Validity evidence based on relationships with other variables was provided by positive and significant correlations between scores on the CD-RISC 10© and scores on emotional intelligence (clarity and repair), life satisfaction, self-esteem and positive affect, and by a negative and significant correlation with negative affect. The majority of these correlations were above |.50|. CONCLUSIONS: The CD-RISC 10© has satisfactory psychometric properties and is a suitable tool for measuring resilience in patients with cancer. The instrument is quick and easy to apply and may be used in both clinical and research contexts.

ANTECEDENTES/OBJETIVO: El objetivo de este estudio fue analizar las propiedades psicométricas de la versión de 10 ítems de la Escala de Resiliencia Connor-Davidson (CD-RISC 10©) en pacientes con cáncer de mama. Método: Una muestra de 169 mujeres españolas que se habían sometido a cirugía por cáncer de mama completaron el CD-RISC 10©, junto con cuestionarios que evaluaban la satisfacción vital, inteligencia emocional, autoestima, y afecto positivo y negativo. Resultados: El análisis factorial confirmatorio apoyó una estructura unifactorial con índices de ajuste adecuados. La fiabilidad se analizó calculando el coeficiente omega de McDonald que arrojó un valor de 0,83. Fue proporcionada evidencia de validez de relación con otras variables mediante correlaciones positivas y significativas entre las puntuaciones en el CD-RISC 10© y las puntuaciones en inteligencia emocional (claridad y reparación), satisfacción vital, autoestima y afecto positivo, y por una correlación negativa y significativa con afecto negativo. La mayoría de estas correlaciones estaban por encima de 50|0,50|. Conclusiones: El CD-RISC 10© tiene propiedades psicométricas satisfactorias, siendo una herramienta adecuada para medir la resiliencia en pacientes con cáncer. El instrumento es rápido y fácil de aplicar y puede usarse tanto en contextos clínicos como de investigación.

Medicina psicosomática en enfermedad cardiovascular II* Consideraciones sobre el tratamiento / Psychosomatic Medicine in Cardiovascular Illness II

Objetivo: brindar orientación sobre las conductas terapéuticas farmacológicas, psicoterapéuticas y otras que se deben instaurar en pacientes con enfermedad cardiaca y trastornos psicoemocionales que le preceden o son consecuencia de ella. Método: se exponen las consideraciones básicas del tratamiento, los fundamentos generales de las psicoterapias que deben emplearse y una breve descripción de cada una de ellas y de las técnicas que se deben instaurar en este tipo de pacientes. Se termina con las recomendaciones farmacológicas, donde se incluyen guías de formulación, riesgos de eventos adversos de psicofármacos, dosis y seguridad de los antidepresivos, ansiolíticos y moduladores del afecto. Resultados: se introduce a consideraciones terapéuticas generales que se deben tener presentes en el paciente con cardiopatía deprimido, ansioso o estresado. Se determinan las actividades que deben ser promovidas para un estilo de vida saludable que disminuya los riesgos de cardiopatías, depresión, ansiedad y estrés. Conclusiones: la consideración de tratamientos psicoterapéuticos, de diferentes modalidades, es prioritaria para disminuir los riesgos y el agravamiento de los padecimientos.

Objective: To provide an orientation on pharmacological therapeutic conducts, psychotherapy and others which should be implemented in patients with cardiovascular disease and psychological and emotional disorders that precede or appear as a consequence of them. Method: This review exposes basic treatment considerations, general basis on psychotherapy with a brief description of each of them and the techniques that should be implemented in these types of patients. Pharmacological recommendations including guides for prescription, psychiatric pharmacological agents risk of adverse effects, dosage and security profile of antidepressants, anxiolytics and mood stabilizers are addressed. Results: This paper reviews the general therapeutical considerations that should be considered in a cardiac disease patient with depression, anxiety or stress. Lifestyle modifications and healthy habits currently recommended to decrease the risk of cardiopathy, depression, anxiety and stress are determined. Conclusions: in order to reduce risks and worsening of illness a priority should be made in regards to psychotherapeutic treatments in their different modalities.

Medicina psicosomática en enfermedad cardiovascular: consideraciones clínicas / Psychosomatic Medicine Treatments in Cardiovascular Illness

El artículo permite concebir la relación entre la enfermedad cardiaca y los estados psicoemocionales que le preceden o son consecuencia de ella. La introducción nos brinda datos estadísticos de diversos estudios clínicos y epidemiológicos que relacionan las enfermedades cardiacas con trastornos depresivos o ansiosos, estrés y el tipo de personalidad. La segunda parte se refiere, primero, a los aspectos clínicos psicoemocionales básicos, cuyos impactos biológicos se constituyen en factores de riesgo de enfermedad cardiaca, y, segundo, a los procesos inherentes a las cardiopatías, que a su vez determinan la aparición de depresión y ansiedad. Se analizan los aspectos básicos de la personalidad Tipo A y su relación con las cardiopatías; así mismo, la cascada biológica desencadenada por el estrés que predispone a alteraciones cardiacas. Finalmente, se exponen unas breves conclusiones y recomendaciones, así como de la bibliografía consultada.

Recent studies provide clear evidence that psychosocial factors contribute significantly to the pathogenesis and expression of coronary disease. This evidence is composed largely of data relating cardiac disease risk to 5 specific psychosocial domains: (1) depression, (2) anxiety, (3) personality factors and character traits, (4) social isolation and (5) chronic and acute life stress. Pathophysiological mechanisms underlying the relationship between these entities can be due to a excessive sympathetic nervous system activation, endothelial dysfunction, immunological and hematological abnormalities. In this review, we examine new epidemiologic evidence for the association between psychosocial risk factors and cardiac disease, identify pathologic mechanisms that may be responsible, and describe a paradigm for studying positive psychologic factors that may act as a buffer; also we review new approaches to improve the delivery of behavioral services and patient compliance. These are part of an emerging field of behavioral cardiology, which is based on the understanding that psychosocial and behavioral risk factors for cardiac disease, are not only highly interrelated, but also require team work between the cardiologist and the psychiatrist.

Depresion y educacion: reconocimiento y abordaje por el medico general: experiencia colombiana / Depression and education recognition and attitudes by general practitioner: a colombian experience

Durante los años 1998 y 1999 se implemento en Colombia el Programa Educativo déla WPA/PTD sobre Trastornos Depresivos, con el aval de la Asociación Mundial de Psiquiatría (WPA) y su comité de educación. Se dividió el país en seis regiones para el desarrollo del programa y se asignó a un profesor (médico psiquiatra) previamente capacitado, la realización de los talleres de acuerdo a los contenidos del Módulo General sobre Depresión diseñado por el Comité de Educación y de Expertos de la WPA. Al mismo tiempo se realizó un estudio sobre conocimientos y actitudes de los médicos generales asistentes a los cursos sobre detección, diagnóstico y tratamiento de la depresión. Se presentan las características del estudio y los resultados del mismo