RESUMO
STUDY OBJECTIVE: To assess the effect of pulmonary rehabilitation (PR) on psychosocial morbidity, functional exercise capacity, and health-related quality of life (HRQL) in patients with severe COPD. DESIGN: A prospective, randomized, controlled trial with blinding of outcome assessment and data analysis. SETTING: A tertiary-care respiratory service. PATIENTS: Forty patients (mean age, 65 +/- 8 years [+/- SD]) with severe chronic flow limitation (FEV(1), 35 +/- 13%) without respiratory failure (Pao(2), 72 +/- 9 mm Hg; Paco(2), 42 +/- 5 mm Hg) were randomized either to a control group or to a PR group (PRG). INTERVENTIONS: Sixteen weeks of PR that included breathing retraining and exercise. MEASUREMENTS: At baseline and 16 weeks, we evaluated psychosocial morbidity using two questionnaires (the Millon Behavior Health Inventory [MBHI] and the Revised Symptom Checklist [SCL-90-R]) and measured 6-min walk distance (6WMD) and HRQL using the Chronic Respiratory Questionnaire (CRQ). RESULTS: We found differences in favor of the PRG in the following MBHI domains: introversive, forceful, and sensitive personality styles (all p = 0.05) and chronic tension (p = 0.01). Results of the depression, hostility, global severity, positive symptom distress index (all p = 0.01), somatization, anxiety, psychoticism, and positive symptom (all p = 0.05) domains of the SCL-90-R favored the PRG. We also found statistically and clinically significant differences between groups in 6MWD (85 m; p < 0.01) and in two domains of the CRQ: dyspnea (1.0; p < 0.01) and mastery (0.6; p < 0.05). The other two domains of CRQ showed strong trends in favor of PRG: 0.7 for both fatigue and emotional function (minimal important difference, 0.5). CONCLUSIONS: PR may decrease psychosocial morbidity in COPD patients even when no specific psychological intervention is performed. Findings from this study also confirm the positive impact of PR on functional exercise capacity and HRQL.
Assuntos
Doença Pulmonar Obstrutiva Crônica/psicologia , Doença Pulmonar Obstrutiva Crônica/reabilitação , Idoso , Exercícios Respiratórios , Exercício Físico , Tolerância ao Exercício , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Testes Psicológicos , Qualidade de Vida , Índice de Gravidade de DoençaRESUMO
The present study examined the psychometric properties of the Spanish version of Moos's Coping Responses Inventory-Youth form in a sample of 1,401 adolescent secondary students (45% boys and 55% girls) ages 12 and 16 years (M = 14.1, SD = 1.4). Basic information as descriptive data and internal consistency reliabilities were given, and intercorrelations for the coping strategies criterion and factorial validity estimated. As in previous reports, the internal consistency was low to moderate. The correlations between scales ranged from .06 to .40. Exploratory factor analysis performed on the coping strategies, with oblimin rotation yielded two factors accounting for 49.6% of variance, which broadly reproduced the Approach-Avoidance dichotomy, with alpha values of .81 and .64, respectively. Finally, the analysis of criterion validity corroborated the relationship between the use of avoidance strategies and higher psychological symptoms.
Assuntos
Adaptação Psicológica , Idioma , Inquéritos e Questionários , Adolescente , Criança , Feminino , Humanos , Masculino , Psicometria/métodos , Reprodutibilidade dos Testes , EspanhaRESUMO
En este trabajo se analizan los cambios producidos en un grupo de 29 enfermos mentales crónicos que seguían un programa de rehabilitación social en los pisos del Centro de Día de Pi i Molist. Para ello se confeccionó un cuestionario que valoraba cinco variables básicas: Días de Ingreso, Habilidades Sociales, Actividades Lúdicas, Relaciones Familiares y Relaciones Sociales. Dicho cuestionario fue administrado sucesivamente durante los años 1993, 1994 y 1995. Los resultados permiten constatar que ha habido cambios significativos en la mayoría de variables, especialmente en la variable Habilidades Sociales y Actividades Lúdicas (AU)
Assuntos
Feminino , Masculino , Humanos , Transtornos Mentais/terapia , Índice de Gravidade de Doença , Doença Crônica , Inquéritos e Questionários , Qualidade de Vida , Atividades Cotidianas , Fatores Etários , Fatores Sexuais , Avaliação de Programas e Projetos de SaúdeRESUMO
Se ha realizado un análisis de validez y fiabilidad del YSR, a partir de la versión española de Lemos, en una muestra de 342 estudiantes de primero de BUP de Barcelona. Como prueba de contraste se ha empleado el Cuestionario de Análisis Clínico de Krug (CAQ). En el YSR, la consistencia interna es más homogénea y elevada para los síndromes de internalización y externalización que para los de banda estrecha. Aparecen covariaciones entre el síndrome de internalización y las escalas de depresión y desajuste psicológico del CAQ, si bien el peso explicativo preferente para dicha internalización viene dado por contenidos psicológicos diferentes para chicos y chicas. El síndrome de externalización, por el contrario, no muestra un patrón consistente de relación con el CAQ (AU)
This work analyses the validity and reliability of the Youth Self Report (YSR), using the Spanish translation by Lemos. The sample was composed of 342 students from Barcelona, that were in their first year of high school. The YSR internal consistency was higher for the Internalizing and Externalizing groupings than for the narrow-band syndromes. The concurrent validity analysis showed relations between the Internalizing YSR grouping and several depression and the Psychological inadequacy CAQ scales. On the contrary, the Externalizing grouping did not show a consistent relational pattern to CAQ scales. It can be added, that for boys and girls the explanation of Internalizing problems was linked to different psychological contents (AU)
Assuntos
Adolescente , Feminino , Masculino , Humanos , Autoavaliação (Psicologia) , Comportamento do Adolescente/psicologia , Distribuição por Sexo , Sintomas Comportamentais/epidemiologia , Valor Preditivo dos Testes , Testes Psicológicos/estatística & dados numéricosRESUMO
Se presenta un sistema de codificación que permite analizar los problemas libremente expresados por los adolescentes según cuatro categorías (naturaleza, contenido, participantes y contexto), que pueden combinarse entre sí. Los índices de fiabilidad, Kappa de Cohen, son adecuados. Se han identificado los problemas de 1.362 adolescentes de entre 12 y 16 años, que cursan Enseñanza Secundaria Obligatoria, y se ha analizado su frecuencia, según sexo. La combinación de las cuatro categorías indica que el 50% de problemas se reducen a tres tipos básicos: problemas interpersonales de relación con compañeros, que afectan mayoritariamente a chicas; problemas de rendimiento escolar, cuyo protagonista es el propio individuo, que afectan preferentemente a chicos; y problemas ajenos, relativos a muertes de familiares, que preocupan por igual a ambos sexos. Se argumenta que el estudio de las relaciones entre life events y salud mental debe contemplarse desde una perspectiva multiaxial, como la propuesta en este trabajo (AU)
This study presents a system of classification which allows to analyze the problems expressed by adolescents in four combinable categories (nature of problem, content, participants and context). Cohens Kappa offers adequate reliability indexes. This system was applied to the problems expressed by 1362 Secondary School adolescents ranging in age from 12 to 16, and the frequency of these problems was analyzed according to gender. The combination of the four categories indicates that 50% of the problems explained by the sample are: a) interpersonal problems with peers, which mainly affect girls; b) school achievement problems, mainly affecting boys; and c) problems of others, principally related to relativess death and which affect both girls and boys. From the results obtained it is advisable to analyze the relationship between life-events and mental health from a multiaxial perspective (AU)