ABSTRACT
Este estudio tuvo como objetivo evaluar el efecto de una intervención cognitivo conductual en la sintomatología de depresión, ansiedad y estrés, la sobrecarga percibida y la calidad de vida en cuidadores de niños con trastorno del espectro autista. Se realizó un estudio experimental con grupo intervención y control, con mediciones de autorreporte pretest-postest. Participaron en el estudio un total de 53 cuidadores: 22 en el grupo experimental y 31 en el grupo control en lista de espera. La mayoría de los participantes fueron mujeres de entre 35 y 64 años, casadas o en una relación formal, con estudios profesionales o superiores y que realizaban alguna actividad remunerada. Los resultados del análisis intergrupal mostraron una disminución de la sintomatología asociada al estrés y sobrecarga percibida y un aumento en la calidad de vida en el grupo experimental. Los datos intragrupales dan cuenta de que, los sujetos del grupo control no tuvieron cambios en ninguna variable, por el contrario, en el grupo experimental se observa una disminución significativa en los índices de ansiedad, estrés y sobrecarga percibida y un aumento en la calidad de vida. Todos estos cambios ocurrieron con tamaños de efecto mediano y grande. Se analizan los mecanismos de cambio y se discuten los hallazgos del estudio a la luz de sus limitaciones. Se concluye que una intervención cognitivo conductual es una estrategia con efectos positivos para brindar apoyo psicológico a los cuidadores de niños con autismo. (AU)
This study aimed to evaluate the effect of a cognitive behavioral intervention on symptoms of depression, anxiety and stress, perceived overload and quality of life in caregivers of children with autism spectrum disorder. An experimental study was conducted out with an intervention and control group, with self-report pretest-posttest measurements. A total of 53 caregivers participated in the study: 22 in the experimental group and 31 in the waiting list control group. The majority of participants were women between 35 and 64 years old, married or in a formal relationship, with professional or higher education and who carried out some paid activity. The results of the intergroup analysis showed a decrease in the symptoms associated with stress and perceived overload and an increase in the quality of life in the experimental group. Intra-group data showed that the subjects of the control group had no change in any variable, in contrast, in the experimental group there was a significant decrease in anxiety, stress and perceived overload indices and an increase in the quality of life. All these changes occurred with medium and large effect sizes. The mechanisms of change are analyzed and the study's findings are discussed in light of its limitations. It is concluded that a cognitive behavioral intervention is a strategy with positive effects for providing psychological support to caregivers of children with autism. (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Autistic Disorder/therapy , Caregivers/psychology , Cognitive Behavioral Therapy , Mental Health , Research Design , Cluster Analysis , Control Groups , Quality of Life , Depression , Anxiety , Stress, PsychologicalABSTRACT
INTRODUCTION: Rheumatoid arthritis (RA) has female preponderance and interferes with the ability to perform job roles. Household work has 2 dimensions, paid and unpaid. There is not a validated instrument that assesses the impact of RA on limitations to perform household work. We report the development and validation of a questionnaire that assesses such limitations, the HOWL-Q. METHODS: The study was performed in 3 steps. Step-1 consisted on HOWL-Q conceptual model construction (literature review and semi-structured interviews to 20 RA outpatients and 20 controls, household workers, who integrated sample (S)-1). Step-2 consisted of instructions selection (by 25 outpatients integrating S-2), items generation and reduction (theory and key informant suggestions, modified natural semantic network technique, and pilot testing in 200 household workers outpatients conforming S-3), items scoring, and questionnaire feasibility (in S-3). Step-3 consisted of construct (exploratory factor analysis) and criterion validity (Spearman correlations), and HOWL-Q reliability (McDonald's Omega and test-retest), in 230 household work outpatients integrating S-4. RESULTS: Patients conforming the 4 samples were representative of typical RA outpatients. The initial conceptual model included 8 dimensions and 76 tasks/activities. The final version included 41 items distributed in 5 dimensions, was found feasible and resulted in 62.46% of the variance explained: McDonald's Omega = 0.959, intraclass-correlation-coefficient = 0.921 (95% CI = 0.851-0.957). Moderate-to-high correlations were found between the HOLW-Q, the HAQ, the Quick-DASH and the Lawton-Brody index. HOWL-Q score ranged from 0 to 10, with increasing scores translate into increase limitations. CONCLUSION: The HOWL-Q showed adequate psychometric properties to evaluate household work limitations in women with RA.