Dietary habits in patients with fibromyalgia: a cross-sectional study.

OBJECTIVES: To the scarce information on dietary habits in fibromyalgia (FM), it is added that there are no comparative studies with other rheumatic diseases. The objective of this study was to characterise the dietary habits of patients with FM by comparing, for the first time, with healthy controls (HC) and rheumatoid arthritis (RA). METHODS: This cross-sectional, observational study was based on data obtained from the Dietfibrom project for FM and from the IMID Consortium for RA and HC. All participants completed a food frequency questionnaire evaluating their weekly dietary intake of main food groups. The three cohorts were compared using a multiple logistic regression model adjusted for age, sex, and body mass index. RESULTS: After quality control, n=287 FM, n=1,983 HC and n=1,942 RA patients were analysed. We found that FM had a profound impact in the diet compared to HC, reducing the consumption of dairy (OR=0.32, p<0.0001), bread and/or whole grain cereals (OR=0.59, p=0.0006), fresh fruit (OR=0.66, P=0.008), and fish (OR=0.64, p=0.002). These same four food groups were also significantly reduced in FM patients in comparison to RA patients (p<0.0005 in all cases). Additionally, a lower consumption of pasta, rice and/or potatoes was also observed in FM compared to RA (OR=0.72, p=0.028). CONCLUSIONS: The present cross-sectional study shows that FM is associated to a significant change in the normal dietary patterns. These results underscore the importance of diet in this prevalent disease and are a warning of the potential long-range effects of a deficient nutritional status.

Characterization of Burnout Among Spanish Family Physicians Treating Fibromyalgia Patients: The EPIFFAC Study.

OBJECTIVE: Burnout among physicians has increased, affecting not only doctors but also the quality of patient care. Treating challenging disorders, such as fibromyalgia, may increase the risk of feeling burned out. Health care of fibromyalgia patients is increasingly being assigned to family physicians. Therefore, we described the demographic characteristics, work contexts, component burnout scores (exhaustion, depersonalization, and personal accomplishment), and perceptions of fibromyalgia care of Spanish family medicine physicians with high and low levels of burnout. We then evaluated which of these variables were associated with having high or low levels of burnout. METHOD: This cross-sectional study assessed 506 family physicians recruited from the Spanish Society of Family Physicians and randomly selected from Primary Health Care Centers. The subgrouping of family physicians based on their burnout scores was assessed by cluster analysis. Variables showing statistically significant differences between clusters and significance below 0.25 in univariate logistic regressions were assessed by multivariate logistic regression analysis. RESULTS: Family physicians reporting higher burnout scores (25%) felt that fibromyalgia patients on sick leave increased their workload, reported no support from nurses in the treatment of fibromyalgia patients, and had a more negative impression of fibromyalgia patients. CONCLUSIONS: One-quarter of family physicians reported feeling exhausted, detached from fibromyalgia patients, or less professionally accomplished. Several personal characteristics and contextual variables increased burnout. Several interventions to modify these variables and, thus, protect family physicians treating fibromyalgia from burnout are suggested.

Belief in a Just World and Emotional Intelligence in Subjective Well-Being of Cancer Patients.

The study of coping strategies has provided valuable insights about the process of helping cancer patients adapt to their disease. However, new approaches must be explored to increase the knowledge of this adjustment. In this study, we will analyze the relationship between patients' psychological well-being and quality of life and less well-studied constructs such as the belief in a just world (BJW) and emotional intelligence (EI). Sixty-eight cancer patients (35 men, 33 women; mean age 53.5 years; range: 20-86) were asked about their personal and general BJW, EI, Perception of Quality of Life, Anxiety, and Depression. Different multiple regression analyses showed that patients' personal BJW negatively predicted their anxiety (p < .05) and a trend to a better quality of life. In addition, patients with high scores in the Mood Repair subfactor of EI showed better quality of life (p < .05), and those with higher Attention to Feelings exhibited more Anxiety (p < .01) and a trend to more Depression. These results underline the need to take into consideration new factors, such as BJW and EI, in clinical interventions for cancer patients.

Belief in a just world and emotional intelligence in subjective well-being of cancer patients

The study of coping strategies has provided valuable insights about the process of helping cancer patients adapt to their disease. However, new approaches must be explored to increase the knowledge of this adjustment. In this study, we will analyze the relationship between patients' psychological well-being and quality of life and less well-studied constructs such as the belief in a just world (BJW) and emotional intelligence (EI). Sixty-eight cancer patients (35 men, 33 women; mean age 53.5 years; range: 20-86) were asked about their personal and general BJW, EI, Perception of Quality of Life, Anxiety, and Depression. Different multiple regression analyses showed that patients' personal BJW negatively predicted their anxiety (p < .05) and a trend to a better quality of life. In addition, patients with high scores in the Mood Repair subfactor of EI showed better quality of life (p < .05), and those with higher Attention to Feelings exhibited more Anxiety (p < .01) and a trend to more Depression. These results underline the need to take into consideration new factors, such as BJW and EI, in clinical interventions for cancer patients

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Factors Influencing Cognitive Impairment in Neuropathic and Musculoskeletal Pain and Fibromyalgia.

Objective: To assess cognitive performance of chronic pain (CP) patients diagnosed with three types of pain-neuropathic pain (NP), musculoskeletal (MSK), and fibromyalgia (FM)-and to analyze the factors influencing cognitive difficulties in each group. Methods: Two hundred fifty-four CP patients-104 NP, 99 MSK, 51 FM-and 72 pain-free subjects were included in the study. The "Test Your Memory" (TYM) scale was used to assess cognitive performance. Pain intensity was measured by means of the visual analog scale (VAS); the Hospital Anxiety and Depression scale was used to assess mental status, and the Medical Outcome Study (MOS) sleep scale to assess sleep quality. The relationships between cognitive performance and these factors were analyzed using linear regression models. Results: The mean score in the TYM was significantly lower (worse cognitive function) in CP patients than controls (40.5 vs 43.9, P < 0.001). In the separate analysis of each group, depression was observed to have a negative impact on MSK pain patients (ß = -0.37, 95% confidence interval [CI] = -0.53 to -0.2, P < 0.001) and on FM subjects (ß =-1.01, 95% CI = -1.05 to -2.38, P = 0.022). A significant interaction between pain intensity and depression was observed in the FM patients. In addition, a U-shaped association was found between the duration of pain and cognitive performance in the NP patients. Neither anxiety nor sleep impairment affected cognitive performance in any of the CP patients. Conclusions: These results highlight the importance of taking into account the type of pain when assessing cognitive performance in CP patients and demonstrate the influence of the emotional state of the patient, especially if depression is present.

Relationship Between Using Clinical Practice Guidelines for Pain Treatment and Physicians' Training and Attitudes Toward Patients and the Effects on Patient Care.

AIMS: To determine the use of clinical practice guidelines (CPGs) for chronic pain (CP) management; analyze the effects of training in pain and the attitudes of physicians toward pain and CP patients on the adherence to these CPGs; and assess the impact of adherence to CPGs on patient care. METHOD: This was a cross-sectional study in a sample of physicians involved in CP patient management. Information on the use of CPGs for CP management, their training in pain, and their attitudes toward pain, patients, and patient care was collected. Descriptive and bivariate analyses were performed, and a multinomial logistic regression model was constructed to analyze factors associated with the use of CPGs. RESULTS: Of the 257 physicians surveyed, 46.6% were physiatrists, 26.7% were general practitioners, and 26.7% were medical oncologists. Although 96.5% claimed to have received training in pain, only 10.1% had received college training, and 76.3% expressed having gaps in their knowledge; 53.9% stated they applied CPGs often/always, and 12.5% rarely/never. Limited knowledge on pain, reduced involvement in training activities, more negative attitudes toward patients, and having experienced CP were the factors related to reduced adherence to CPGs, especially among the youngest respondents. The greater the use of CPGs, the better the patient care was. CONCLUSIONS: Access to scientific information and specialized training are factors related to the use of CPGs for pain treatment. Therefore, the inclusion of CP training in university and during medical specialty training will be essential measures to improve adherence to CPG, thereby improving patient care and pain control.

Nationwide cross-sectional study of the impact of chronic pain on an individual's employment: relationship with the family and the social support.

OBJECTIVES: To determine the prevalence and the factors related to sick leave and job loss among individuals suffering from chronic pain (CP), and to analyse specifically the effect of family and social support on the individual's employment. DESIGN: Observational cross-sectional study. SETTING: Data were collected using structured computer-assisted telephone interviews between February and June 2011. PARTICIPANTS: A nationwide study of 1543 Spanish adults of working age (<65), 213 of whom suffered from CP (pain suffered at least 4 or 5 days a week during the past 3 months, according to the criteria of the International Association for the Study of Pain (IASP)). MAIN OUTCOME MEASURE: Information was collected regarding the individual's sociodemographic status, pain characteristics, healthcare use and satisfaction, limitations in daily activities, mood status, perception of the impact of pain on their families, and their satisfaction with the family and social support. To identify factors associated with sick leave and job loss among those suffering CP, 2 logistic regression models were generated. RESULTS: The prevalence of sick leave due to CP in the general Spanish population was 4.21% (95% CI 3.2% to 5.2%). Sick leave were more likely for individuals who considered their family were affected by their pain (OR=2.18), needed help to dressing and grooming (OR=2.98), taking medication (OR=2.18), had a shorter pain duration (OR=0.99) and higher educational level. The prevalence of job loss due to CP was 1.8% (95% CI 1.1% to 2.5%). It was related to feelings of sadness (OR=4.25), being unsatisfied with the care provided by health professionals (OR=2.60) and consulting a doctor more often due to CP (OR=1.09). CONCLUSIONS: CP is negatively associated with an individual's employment. This detrimental effect could be ameliorated if the factors related to sick leave and job loss provoked by CP are identified, especially those related to the effect of CP on the family and social environment.

Aplicación y evaluación de los métodos de aprendizaje activo colaborativo en la docencia de Salud Pública en Fisioterapia / Implementation and evaluation of collaborative active learning methods in the teaching of Public Health in Physiotherapy

INTRODUCCIÓN: Dadas las ventajas de metodologías de aprendizaje activo colaborativo se plantea establecer una enseñanza de Salud Pública basada en estas metodologías, evaluarla y detectar la satisfacción del alumno con este método. MATERIAL Y MÉTODOS: Estudio descriptivo transversal en el que se aplicó aprendizaje activo colaborativo a alumnos de Salud Pública del tercer curso de Fisioterapia de la Universidad de Cádiz. Para evaluar esta metodología se recogió información sobre entrega y superación de actividades y se utilizó una encuesta para conocer la satisfacción del alumnado. RESULTADOS: De los 50 alumnos participantes el 100% entregó todas las actividades planificadas y el 68% superó la asignatura. De los resultados de la encuesta de satisfacción destaca que la elaboración propia del tema les ayudó mucho, pero la explicación de los compañeros no les ayudó lo suficiente para comprender la materia. La mayoría respondió que fue suficiente el tiempo dedicado a la actividad. Tanto la información como la ayuda ofrecida por los profesores en las tutorías la consideraron buena/muy buena.comparando con otros métodos tradicionales de enseñanza-aprendizaje no existió unanimidad. Se obtuvieron 6,3 y 7,3 puntos (sobre 10) en la valoración de la actividad y de la labor educativa de los profesores, respectivamente. CONCLUSIÓN: Se debe continuar proyectando esta experiencia en cursos posteriores y plantearla de forma común en el Grado, para aumentar su efectividad y acercarse aún más a los retos que plantea el proceso de convergencia al espacio europeo de educación superior

INTRODUCTION: Given the advantages of collaborative active learning methodologies, we propose to establish a Public Health education based on these methodologies, evaluate it and detect student satisfaction with this method. MATERIAL AND METHODS: Cross-sectional study in which active learning collaborative was applied to students of Public Health in the third year of Physiotherapy at the University of Cadiz. To evaluate this methodology, information on delivery and improvement of activities were collected and was used a survey on student satisfaction. RESULTS: Of the 50 students participating, 100% delivered all planned activities and 68% passed the subject. From the results of the satisfaction survey it highlights that the own elaboration of the theme helped them a lot, but the explanation of the partners did not help them enough to understand the subject. Most responded that time spent on the activity was enough. Both, the information and the assistance offered by teachers in tutorials were considered good/very good.comparing with other traditional methods of teaching and learning, there was no unanimity.6.3 and 7.3 points (out of 10) were obtained in the evaluation of the activity and educational work of teachers, respectively. CONCLUSIÓN: This experience should continue being projected in subsequent years and raise it in the Grade to increase its effectiveness and get closer to the challenges of the process of convergence to the European higher education área

A review of chronic pain impact on patients, their social environment and the health care system.

Chronic pain (CP) seriously affects the patient's daily activities and quality of life, but few studies on CP have considered its effects on the patient's social and family environment. In this work, through a review of the literature, we assessed several aspects of how CP influences the patient's daily activities and quality of life, as well as its repercussions in the workplace, and on the family and social environment. Finally, the consequences of pain on the health care system are discussed. On the basis of the results, we concluded that in addition to the serious consequences on the patient's life, CP has a severe detrimental effect on their social and family environment, as well as on health care services. Thus, we want to emphasize on the need to adopt a multidisciplinary approach to treatment so as to obtain more comprehensive improvements for patients in familial and social contexts. Accordingly, it would be beneficial to promote more social- and family-oriented research initiatives.

Use and satisfaction with the Healthcare System of the chronic pain patients in Spain: results from a nationwide study.

OBJECTIVE: To analyze the use of healthcare resources by chronic pain (CP) patients in Spain and their satisfaction with them. RESEARCH DESIGN AND METHODS: A nationwide, cross-sectional study was carried out on a representative sample of 1957 Spanish adults. A telephone survey was conducted with the aim of analyzing the prevalence of CP, the characteristics and consequences of pain, the use of healthcare resources and patients' satisfaction with them. Descriptive, bivariate and multivariate analyses were performed. RESULTS: Of the 1957 subjects interviewed, 325 suffered CP. The mean duration of CP was 10 years (SD: 11.3) and 48.9% of the CP sufferers reported severe/unbearable pain. Moreover, about 30% felt sad/very sad or anxious/very anxious, 24.4% had been on sick leave, 12% had left/lost their jobs and 47.2% considered their pain affected their families. Likewise, 92.9% had consulted a healthcare professional due to their CP, on average 3.49 times (SD: 3.9), and 69.2% took medication. In addition, 67.3% and 63.8% were satisfied/very satisfied with the care and the healthcare information they received, respectively. Individuals who reported headache (OR = 0.34) and feeling sad (OR =0.38) were least satisfied with the care they received. In addition, CP sufferers who made greater use of consultations were those who had left/lost their jobs (ß = 1.44), those who took medication (ß = 1.67), those who considered their pain affected their families (ß = 0.97) and those with a shorter duration of pain (ß = -0.003). CONCLUSIONS: CP produces relevant demands on healthcare resources, conditioned by the consequences within the family and the effects on their employment. To achieve greater patient satisfaction, professionals need to pay particular attention to certain sites of pain and to patients' mental health.

Generalized Estimating Equations (GEE) to handle missing data and time-dependent variables in longitudinal studies: an application to assess the evolution of Health Related Quality of Life in coronary patients.

OBJECTIVES: to analyse the evolution of Health Related Quality of Life (HRQL) in coronary patients (CP) and to identify predictive factors influencing this evolution in a situation with missing data and time-dependent variables. DESIGN: prospective study with repeated measures. SETTING AND PARTICIPANTS: a total of 175 CP were included. General Estimating Equations (GEE) models were used to assess the evolution of HRQL in these patients. These models, not commonly used in this context, are applied here as an alternative to traditional techniques that do not handle missing data and time-dependent covariates properly. MAIN OUTCOME MEASURES: HRQL assessed by SF-36v1 Questionnaire at baseline, 3 and 6 months after discharge. RESULTS: role physical, bodily pain, general health, vitality, and the physical component summary of SF-36 improved over the follow-up. Being woman, older, and having higher scores on GHQ-28 were associated to a decrease in HRQL throughout time. Previous history of coronary heart disease, comorbidities, revascularisation, rehospitalisation, and episode of angina had a negative impact on HRQL, especially between 3 and 6 months after discharge. CONCLUSION: the analysis of the evolution of HRQL with a longitudinal approach using GEE models shows the predictive effect of the variables analysed during the follow-up, including the time itself and time-dependent covariates such as the evolution of mental health. In addition, it allows to particularise the predictive effect of covariates at each period within the follow-up.

Simple generalized estimating equations (GEEs) and weighted generalized estimating equations (WGEEs) in longitudinal studies with dropouts: guidelines and implementation in R.

Missing data are a common problem in clinical and epidemiological research, especially in longitudinal studies. Despite many methodological advances in recent decades, many papers on clinical trials and epidemiological studies do not report using principled statistical methods to accommodate missing data or use ineffective or inappropriate techniques. Two refined techniques are presented here: generalized estimating equations (GEEs) and weighted generalized estimating equations (WGEEs). These techniques are an extension of generalized linear models to longitudinal or clustered data, where observations are no longer independent. They can appropriately handle missing data when the missingness is completely at random (GEE and WGEE) or at random (WGEE) and do not require the outcome to be normally distributed. Our aim is to describe and illustrate with a real example, in a simple and accessible way to researchers, these techniques for handling missing data in the context of longitudinal studies subject to dropout and show how to implement them in R. We apply them to assess the evolution of health-related quality of life in coronary patients in a data set subject to dropout. Copyright © 2016 John Wiley & Sons, Ltd.

Methods and Instruments to Evaluate Cognitive Function in Chronic Pain Patients: A Systematic Review.

OBJECTIVE: We aimed to systematically review the methods and instruments used to evaluate cognitive function in chronic pain (CP) patients. METHODS: A sensitive search strategy was designed using five databases. Based on the objectives and methodology, we selected cross-sectional studies on adults with chronic non-cancer pain in which cognitive function was assessed using validated instruments. The characteristics of the subjects, control groups, and other variables that might affect cognitive function, and the instruments used, were extracted from each article. RESULTS: In the 42 articles identified, 53 instruments were used to assess cognitive function. Chronic pain criteria were defined in 83.3% of the articles and more than half (57.1%) included single diagnosis samples, with fibromyalgia being the most frequent studied (75%). Patients with prior cognitive impairment were excluded in 61.9% of the studies, and a control group was included in 64.3% of the studies. In most cases potential confounding variables were evaluated. More than 14% of the studies used self-report measures, and 73.8% used neuropsychological instruments, particularly for assessing attention (30%) and memory (27.5%). None of the instruments were specifically validated for pain patients and only five studies analyzed the psychometric properties of the instruments. CONCLUSIONS: Various instruments and methods were used to assess cognitive function in CP patients, particularly fibromyalgia patients, but also other cohorts with well-defined CP. The instruments used had been validated, but not for pain populations, thus they require specific adaptation and validation to be used in CP patients. Certain recommendations are made in order to improve the evaluation of cognitive function in these patients.

A nationwide study of chronic pain prevalence in the general spanish population: identifying clinical subgroups through cluster analysis.

OBJECTIVE: This study aims to assess the prevalence of chronic pain, its characteristics, and its impact on the general Spanish population. Also, to establish chronic pain patient subgroups according to the characteristics of pain and to identify variables specifically associated with each subgroup. DESIGN: Telephone-based, cross-sectional nationwide study. SUBJECTS: A sample of 1,957 individuals representative of the Spanish population. METHODS: Data were collected through telephone interviews. A subject was considered to have chronic pain if they had suffered pain (at least 4 days a week) during the last 3 months. The subjects were divided into two subgroups through a cluster analysis, and a regression model was established to determine the variables most specifically associated with these subgroups. RESULTS: The prevalence of chronic pain was 16.6% (95% confidence interval: 14.9-18.3) and among these subjects, more than 50% referred to limitations in their daily activities, 30% felt sad and/or anxious, and 47.2% indicated that their pain was affecting their family life. Two subgroups of subjects with pain were identified: 1) characterized by generalized pain in more than one location and of a long evolution (150 months); and 2) characterized by pain localized to only one site with a shorter duration (100 months). Individuals who felt anxious because of their pain and those who considered that their pain was affecting their family were more likely to belong to group 1. CONCLUSIONS: Pain affects an important proportion of the Spanish adult population and that it has a strong personal impact. Two pain groups were clearly distinguished by their clinical characteristics.

The impact of chronic pain: the perspective of patients, relatives, and caregivers.

To assess the impact of chronic pain on the family environment from the patient's, relative's and caregiver's perspective, we undertook cross-sectional study on a representative sample of Spanish adults who suffered pain at least 4 days a week for ≥3 months and on relatives and caregivers of patients that fulfilled these criteria. The characteristics of pain and the perception of its impact on the family environment were assessed, using logistic regression models to reveal the variables associated with the impact of pain on the family. From a total of 1,957 subjects, 325 experienced chronic pain and 34.6% of them perceived that their pain affected their family environment. These patients recognized a stronger impact when their relatives were sad (OR = 3.61; CI:1.57, 8.27) and had modified the leisure activities because of the pain (OR = 3.62; CI:1.56, 8.38). Among the 131 relatives, 51.2% perceived that pain was affecting the family, causing changes in their leisure activities (OR = 1.17; CI:1.04, 9.94) and sleep disturbance (OR = 1.40; CI:1.32, 12.58). Of the 36 caregivers, mainly women over 50 years of age, 66.7% indicated that pain affected the family, although 72.8% were satisfied with the help they provided. Chronic pain has a very strong impact on the family, although this is perceived distinctly by patients, relatives, and caregivers. Recognizing that factors related to pain affect the family's well-being, and adopting a global approach to pain that takes into consideration the family's experiences, should improve the therapeutic response, and enhance the patient's and relative's quality of life. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Association of painful musculoskeletal conditions and migraine headache with mental and sleep disorders among adults with disabilities, Spain, 2007-2008.

INTRODUCTION: The aim of this study was to determine the prevalence of painful musculoskeletal conditions and migraine headache or any other headache in a sample of Spanish adults with disabilities and their association with anxiety, depression, and sleep disorders. METHODS: This cross-sectional study analyzed data from the Spanish national disability and dependence survey (2007-2008) of 16,932 adults aged 18 or older who have disabilities. The prevalence (95% confidence interval [CI]) of painful musculoskeletal conditions was determined according to a diagnosis of arthritis, osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, muscular dystrophy, and neck or back pain. The prevalence of migraine or other headache was also calculated. Factors associated with these painful conditions were analyzed separately for men and women by using a logistic regression model. RESULTS: The prevalence of painful musculoskeletal conditions was 66.9% (95% CI, 66.2%-67.6%) and that of migraine or other headache was 23.4% (95% CI, 22.8%-24.1%), both of which were higher in women than in men. Factors associated with these conditions in both men and women included older age, a sleep disorder, and concomitant chronic anxiety and/or depression. CONCLUSION: The prevalence of painful musculoskeletal conditions and migraine or other headache is high in people with disability in Spain, especially in women, and these conditions often coexist with depression, anxiety, and/or a sleep disorder. To design programs for rehabilitating and improving the quality of life of adults with disability and painful conditions, treatments for mental and/or sleep disorders should be considered in addition to conventional treatments.

Undiagnosed mood disorders and sleep disturbances in primary care patients with chronic musculoskeletal pain.

OBJECTIVE: The study aims to determine the prevalence of undiagnosed comorbid mood disorders in patients suffering chronic musculoskeletal pain in a primary care setting and to identify sleep disturbances and other associated factors in these patients, and to compare the use of health services by chronic musculoskeletal pain patients with and without comorbid mood disorders. DESIGN: Cross-sectional study. SUBJECTS: A total of 1,006 patients with chronic musculoskeletal pain from a representative sample of primary care centers were evaluated. OUTCOME MEASURES: Pain was measured using a visual analog scale and the Primary Care Evaluation of Mental Disorders questionnaire was used to measure mood disorders. RESULTS: We observed a high prevalence of undiagnosed mood disorders in chronic musculoskeletal pain patients (74.7%, 95% confidence interval [CI] 71.9-77.4%), with greater comorbidity in women (adjusted odds ratio [OR] = 1.91, 95% CI 1.37-2.66%) and widow(er)s (adjusted OR = 1.87, 95% CI 1.19-2.91%). Both sleep disturbances (adjusted OR = 1.60, 95% CI 1.17-2.19%) and pain intensity (adjusted OR = 1.02, 95% CI 1.01-1.02%) displayed a direct relationship with mood disorders. Moreover, we found that chronic musculoskeletal pain patients with comorbid mood disorders availed of health care services more frequently than those without (P < 0.001). CONCLUSIONS: The prevalence of undiagnosed mood disorders in patients with chronic musculoskeletal pain is very high in primary care settings. Our findings suggest that greater attention should be paid to this condition in general practice and that sleep disorders should be evaluated in greater detail to achieve accurate diagnoses and select the most appropriate treatment.

Traducción y adaptación al castellano del Cuestionario de Detección de Trastorno Cognitivo Leve / Translation and adjustment into Spanish language of the screening tool for mild cognitive impairment

Fundamento y objetivo: El Test Your Memory (TYM) es una escala que valora deterioro cognitivo leve (DCL) con mejores resultados psicométricos que el Mini-Mental State Examination (MMSE). El objetivo de este trabajo fue traducir y adaptar al castellano una versión conceptualmente equivalente del TYM. Sujetos y método: Traducción-retrotraducción de la escala complementada con metodología cualitativa y prueba piloto en 42 españoles sanos de distintas edades, para evaluar la correcta comprensión del cuestionario. Resultados: Un 54% de los ítems no presentaron dificultad en la adaptación, un 27% mostraron dificultad media y un 18% mayor dificultad. Se realizaron algunas adaptaciones por motivos culturales, gramaticales y conceptuales. La prueba piloto demostró una buena comprensión del cuestionario. Conclusiones: Una vez valorada psicométricamente, esta escala podría ser un instrumento útil para detectar DCL en población española, solventando aquellas necesidades no cubiertas por el MMSE (AU)

Background and objectives: The Test Your Memory (TYM) scale is a screening tool, which assesses mild cognitive impairment (MCI). It has shown better psychometric outcomes than the Mini-Mental State Examination (MMSE). We aimed to translate and adjust into Spanish a conceptually equivalent version.Subjects and method: Translation-back translation method, complemented with qualitative methods, and pilot survey with 42 healthy Spanish people from different group of age to ensure the right comprehension.Results: While translating, 54% of the items presented no difficulty at all; 27%, medium difficulty; 18% high difficulty. Some adaptations were made for cultural, grammatical and conceptual reasons. The pilot survey showed a good comprehension of the test.Conclusions: The TYM test could be a good choice for detecting MCI in the Spanish population and could resolve the problems caused by the limitations of the MMSE (AU)

[Translation and adjustment into Spanish language of the screening tool for mild cognitive impairment]. / Traducción y adaptación al castellano del Cuestionario de Detección de Trastorno Cognitivo Leve.

BACKGROUND AND OBJECTIVES: The Test Your Memory (TYM) scale is a screening tool, which assesses mild cognitive impairment (MCI). It has shown better psychometric outcomes than the Mini-Mental State Examination (MMSE). We aimed to translate and adjust into Spanish a conceptually equivalent version. SUBJECTS AND METHOD: Translation-back translation method, complemented with qualitative methods, and pilot survey with 42 healthy Spanish people from different group of age to ensure the right comprehension. RESULTS: While translating, 54% of the items presented no difficulty at all; 27%, medium difficulty; 18% high difficulty. Some adaptations were made for cultural, grammatical and conceptual reasons. The pilot survey showed a good comprehension of the test. CONCLUSIONS: The TYM test could be a good choice for detecting MCI in the Spanish population and could resolve the problems caused by the limitations of the MMSE.