Prediction of caregiver psychological distress in amyotrophic lateral sclerosis: A cross-sectional study.

PURPOSE/OBJECTIVE: To propose a predictive model for caregivers' psychological distress (including anxiety, depression, and cognitive overload) based on different data gathered from amyotrophic lateral sclerosis (ALS) patients (cognitive level, psychological distress, type of ALS, and sex). RESEARCH METHOD/DESIGN: A cross-sectional study with a sample of 51 ALS patients and their respective main carers. Various instruments were used such as the Beck Anxiety Inventory, ALS Depression Inventory-12, and the Edinburgh Cognitive and Behavioral ALS Screen, Zarit Burden Interview, Self-Rating Depression Scale, and Self-Rating Anxiety Scale for caregivers. RESULTS: ALS type, sex, and cognition were predictive variables for caregiver distress, with the main explanatory variable being the distress of the patients themselves. Spinal ALS led to higher psychological distress in caregivers (ß = .38), as did male patients with ALS and preserved cognition. CONCLUSIONS/IMPLICATIONS: The proposed confirmatory model demonstrates that patients' psychological distress is the best predictor of psychological distress in their caregivers. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Spanish adaptation and validation of the ALS Depression Inventory-12 (ADI-12) in patients with Amyotrophic Lateral Sclerosis.

BACKGROUND: Patients with Amyotrophic Lateral Sclerosis (ALS) have a higher prevalence of mood disorders, including depression, than the general population. Non-specific measurement instruments have been used to evaluate depression in these patients, which complicates accurate diagnosis. The ALS Depression Inventory (ADI-12) exclusively assesses depressive symptoms in patients with ALS. AIM: To adapt and validate the ADI-12 in a Spanish sample. METHODS: A selective design was used with 74 patients with ALS, using the ADI-12 questionnaire. The original instrument was translated and back-translated into Spanish. The internal structure, temporal stability, convergent, and discriminant validity of the instrument were analyzed. RESULTS: Two confirmatory models showed internal validity (p = 0.502 for the one-factor model, p = 0.507 for the two-factor model). The Cronbach's alpha (0.900 in the first measurement and 0.889 in the second one) indicated a high internal consistency of the test. The Pearson correlation (0.90) indicated high temporal stability. In terms of convergent validity, the ADI-12 showed moderate correlations with the Beck Anxiety Inventory (BAI) (0.51-0.58), and low correlations with time since ALS diagnosis (-0.26 to -0.27). LIMITATIONS: The main limitation of the present study was the small sample size. CONCLUSIONS: The ADI-12 is fitted to a single general factor of depression, and the scale shows high internal consistency and high temporal stability, therefore, its use is recommended for the diagnosis of depression in patients with ALS.

Paraoxonase I Activity and Its Relationship with Nutrition in Amyotrophic Lateral Sclerosis.

Background: Amyotrophic lateral sclerosis (ALS) is characterized by progressive motor neuron degeneration, with oxidative stress playing a key role. Paraoxonase 1 (PON1) is an antioxidant enzyme that may influence ALS progression. This study aimed to establish a predictive model for the influence of PON1 activity on functionality in ALS patients and explore its relationship with nutrition. Methods: In this observational cross-sectional study, 70 ALS patients underwent assessments of PON1 activity, lipid profile, functional capacity, respiratory function, and heart rate variability. A structural equation model was developed to determine the relationships between variables. Nutritional intake was analyzed in 65 patients. Results: The predictive model showed that PON1 activity and LDL levels positively influenced functionality, both directly and indirectly through respiratory capacity. Heart rate variability moderately predicted functionality independently. HDL levels were not significantly associated with functionality. Weak to moderate correlations were found between PON1 activity and intake of certain nutrients, with positive associations for monounsaturated fats and vitamin D, and negative associations for carbohydrates, proteins, and some micronutrients. Conclusions: PON1 activity appears to play an important role in ALS patient functionality, both directly and through effects on respiratory capacity. However, its relationship with nutritional intake was not strongly evident in this sample population.

Fear of Falling Score Is a Predictor of Falls in Community-Dwelling Pre-Frail and Frail Older People.

Identifying frail older people at risk of falling is a priority in order to apply preventive strategies. This cross-sectional study included community-dwelling pre-frail and frail people (Fried's criteria) aged 70 years and older to assess the prevalence of falls and identify screening strategies based on comprehensive geriatric assessments to detect an increased risk of falling and recurrent falling in community-dwelling frail and pre-frail old people. Of the 229 participants, 121 (54.9%) had fallen in the previous 12 months, and 20 of these (16.5%) were recurrent fallers (≥2 falls). A score of 20 points or more on the Falls Efficacy Scale International was predictive of falling (area under the receiver-operating characteristics curve 0.67, 95% confidence interval: 0.61-0.74, p < 0.001) with a sensitivity of 51.7% and a specificity of 73.9%. Polypharmacy, Short Physical Performance Battery score of 8 points or less, and Falls Efficacy Scale International score of 20 points or more show an area under the curve of 0.78 (95% confidence interval: 0.67-0.89, p < 0.001) for recurrent falling.

Importance of Soft Skills in Health Sciences Students and Their Repercussion after the COVID-19 Epidemic: Scoping Review.

Soft skills (SKs) are skills related to the interaction among people and their way of dealing with tasks. Increasingly valued in the workplace, they are especially relevant in health professionals due to the importance of the relationship among them and their patients and families. Given their importance, the university training of healthcare professionals must promote the development of SKs. The COVID-19 pandemic has been a turning point in many areas, changing the learning process and, even more, the use of these soft skills as a fundamental ingredient in human relationships. The aim of this study was to analyse the available evidence regarding SKs in health science students, specifically nursing students, and to describe whether there is a worsening in the development of such skills after the COVID-19 pandemic. According to the PRISMA-ScR methodology for systematic reviews, this study included articles on social skills and possible changes in these skills as a consequence of the pandemic in health sciences students The results highlight the importance of these emotional competences for future nurses, being particularly relevant for communication and emotional self-awareness and showing their influence on academic aspects, such as academic performance or mental health and coping skills. A major limitation of the present study was not considering aspects such as compassion or empathy. However, the novelty provided by this work is the analysis of the changes in SKs produced as a consequence of the pandemic. It is definitely clear that there is a need to enhance emotional intelligence, and thus soft skills, in future health professionals.

Impact of Family Function on the Quality of Life and Health Perception of Non-Institutionalized Dementia Patients.

BACKGROUND: Dementia is one of the pathologies that has increased the most among the older population (mainly Alzheimer's disease), and it has a direct impact on the quality of life (QoL), cognitive performance, and health of these patients. Family functionality can play a role in this QoL if these patients are not institutionalized. OBJECTIVE: To analyze the role of family function in the QoL and health perception of non-institutionalized dementia patients, as well as related variables such as anxiety, depression, optimism, or pessimism. METHODS: Cross-sectional study with a sample of 54 patients diagnosed with some type of dementia, non-institutionalized, or in outpatient care, from different centers in the province of Valencia (Spain). The EQ-5D, MMSE, Apgar Family or general health, and Goldberg anxiety and depression questionnaires were utilized. RESULTS: The correlation of the Apgar Family with the General Health Questionnaire-new onset problems variable (GHQ) and Chronicity and General Health Questionnaire-chronic problems (CGHQ) of the Goldberg Quality of Life questionnaire was statistically significant and negative (GHQ r = -0.310; p = 0.034. CGHQ r = -0.363; p = 0.012); as well as between Apgar Family and Anxiety-Depression (r = -0.341; p = 0.020). The correlation of the Apgar Family with the Life Orientation Test-Pessimism variable (LOT) was statistically significant and negative (r = -0.270; p = 0.061). Finally, severe dysfunction of Apgar Family has a negative correlation with self-perception of health (p = 0.036 B = -16.589) determined by the Visual Analogue Scale (VAS). CONCLUSION: Family functionality directly influences anxiety, depression, optimism, and pessimism. This could explain why family function is related to the QoL of patients and their self-perception of health.

Acceptability of the Vaccine against COVID-19 in Spanish Health Sciences Students: A Cross-Sectional Study.

Healthcare professionals must play an exemplary role in the field of vaccinology. It is convenient that they are trained during their time at university. The objective of this study was to determine the acceptability of the vaccines against COVID-19 in health sciences students in Spanish universities. A cross-sectional study was performed regarding the acceptance of the vaccines against COVID-19 in students in the Health Sciences Degrees in Spanish universities was performed on a sample of students of nursing, medicine, and pharmacy during the spring of 2021, via an online questionnaire with 36 questions designed ad hoc, self-administered, anonymized, and standardized. There were 1222 students participating, of Spanish nationality (97.4%), women (80.5%) and with an average age of 22.0 ± 4.8 years old. Of those, 12.3% had had the disease, 44.0% had to quarantine, 70.8% had undergone diagnostic tests, out of which 14.1% were positive. In total, 97.5% of those surveyed indicated their desire of being vaccinated, if possible, with Comirnaty® (74.9%). At the time of the study, 49.6% were already vaccinated. The reasons for vaccination differed according to the degree and the doubts about vaccine safety was the largest reason for reluctance. Some 37.7% suspected that there are unknown adverse effects and 85.6% of those vaccinated experienced some mild effects after injection. Vaccine acceptance and confidence in the recommendations given by health authorities is high in health sciences students.

Preferred Music Listening Intervention in Nursing Home Residents with Cognitive Impairment: A Randomized Intervention Study.

BACKGROUND: The current trend in addressing symptoms of dementia comprises non-pharmacological strategies such as music interventions for the management and improvement of cognitive function, memory, agitation, depression, or anxiety. OBJECTIVE: To determine the impact of a preferred music listening group intervention upon the functional, cognitive, and emotional dimensions in nursing home residents. METHODS: A randomized intervention study was carried out. The study was conducted from June to August 2015, and involved a preferred music listening group intervention lasting 60 minutes, 5 days/week during 8 weeks. A total of 119 adults aged ≥65 years, with annual permanent residence in the nursing home (Málaga, Spain) were included in the study. 47 (39.5%) subjects were randomized to the music group intervention. The nurses and physiotherapists were blinded to the assessments. RESULTS: The sample had a mean age of 80.52 (SD7.44) years, with female predominance. The subjects presented dependency in Barthel, and cognitive impairment as determined by the MMSE. The Tinetti scores yielded fall risk and depression as evidenced by the Yesavage scale. The Cornell scores evidenced no depression in elderly people with dementia. Following the intervention, function improved significantly with a medium effect size, as did emotional state, with a large effect size. Cognitive function was seen to worsen in the control group, but remained stable in the intervention group, with a large effect size. CONCLUSIONS: A preferred music listening group intervention among elderly people in nursing homes is effective, resulting in improvements in functional and emotional condition.

Análisis de la relevancia percibida del trabajo de planificación compartida de la atención a través de la instrumentalización con cartas / Analysis of the perceived relevance of the work of advance directives through instrumentalization with cards

Objetivo: Desarrollo y evaluación de un instrumento capaz de medir la relevancia percibida del trabajo con cartas para el diálogo acerca de las preferencias en el proceso final de la vida.Método: Se ha construido la escala de la pertinencia percibida acerca del trabajo con cartas para las preferencias al final de la vida la cual ha sido evaluada mediante juicio de expertos y análisis factorial confirmatorio en una muestra de 320 estudiantes de Grado en Enfermería y 68 personas mayores de 40 años.Resultado: Se llega a una solución de 21 ítems, los cuales se ajustan en las 4 dimensiones teórica propuestas de manera óptima (CFI: 0,912; 0,842; 0,816; 0,995; RMSA: 0,170; 0,198; 0,187; 0,076).Conclusiones: La escala de medición de la pertinencia del trabajo con cartas es fiable y válida. Está compuesta por 4 dimensiones: Pertinencia percibida para la formación; Pertinencia percibida para el autoconocimiento; Pertinencia percibida para la aplicación en pacientes; e Iatrogenia percibida del instrumento). (AU)

Objective: Development and evaluation of an instrument capable of measuring the perceived relevance of working with cards for the dialogue about preferences at the end stages of life.Method: A scale to measure the perceived relevance of working with cards for the conversation about preferences at the end of life was developed and evaluated through expert judgment and confirmatory factor analysis in a sample of 320 nursing degree students and 68 people older than 40 years.Result: A solution with 21 items was reached, which optimally fitted the four proposed theoretical dimensions (CFI: 0.912; 0.842; 0.816; 0.995; RMSA: 0.170; 0.198; 0.187; 0.076).Conclusions: The scale for measuring the relevance of working with cards is reliable and valid. It is made up of four dimensions: Perceived relevance for training; Perceived relevance for self-knowledge; Perceived relevance for application in patients; and Perceived iatrogenicity of the instrument). (AU)