The psychological well-being index and quality of life after a cardiac rehabilitation program based on aerobic training and psychosocial support.

BACKGROUND: This study aimed to investigate the physical and psychological benefits of an alternative cardiac rehabilitation program based on therapeutic groups during physical exercise sessions and to compare the results with those of a conventional cardiac rehabilitation program. METHOD: The sample included 112 patients from the cardiac rehabilitation unit of a medical center, 91.1 % of whom were male. The control group consisted of 47 subjects, with a mean age of 57.89 ± 12.30 and the experimental group consisted of 65 subjects, with a mean age of M = 58.38 ± 9.86. Quality of life, psychological well-being, health-related quality of life, body mass index, blood pressure, abdominal circumference and resting heart rate were measured before starting and at the end of the cardiac rehabilitation program. RESULTS: The experimental group improved significantly more than the control group in body mass index, systolic and diastolic blood pressure, abdominal circumference, and resting heart rate (p value < 0.005). In addition, the experimental group had significantly greater improvements in quality of life, psychological well-being, and health-related quality of life than the control group (p-value < 0.001). CONCLUSIONS: A cardiac rehabilitation program based on simultaneous aerobic training and psychosocial support improved the physical function, health-related quality of life and well-being.

Prevalence of Burnout Syndrome and Job Satisfaction in Music Therapists in Spain: A Cross-Sectional, Descriptive Study.

BACKGROUND: Burnout syndrome and job satisfaction are topics of increasing interest due to their relevance in people's health and well-being. Besides, they are considered very relevant in the fields of social and health care studies. OBJECTIVE: The objective of this study was to analyse the professional profile of music therapists in Spain and the prevalence of burnout syndrome and job satisfaction among them. METHODS: This was an observational, descriptive, cross-sectional study, carried out using an ad-hoc online questionnaire, the Maslach Scale and the general satisfaction scale on a sample of employed Spanish music therapists with more than two years of working experience in Spain. RESULTS: Eighty questionnaires were analysed. The majority of the participants were between 30-39 years old (38.8%) and were women (85%). They combined their profession with other occupations (76.3%), mostly in care roles with a fix term contract and were self-employed (40%). The prevalence of burnout syndrome was 3.8% (p < 0.001) and the predisposition or tendency to develop this condition was over 57.5% (p < 0.001). The highest levels of burnout syndrome were found in professionals with trainee contracts (p = 0.001), in those who were providing training (p = 0.021), who attended 6 to 10 patients per week (p = 0.001), who were usually working with a therapist colleague (p = 0.046) and those who did not take prescribed psychotropic drugs (p = 0.034). The highest level of job satisfaction was observed in music therapists working in the field of disability (p = 0.010) and mental health (p = 0.022) and with seniority in their job position. The lowest level of job satisfaction was seen in music therapists with trainee contracts (p = 0.041), with less working hours per week (p = 0.016), working in the field of education (p = 0.006) and in those who did not feel valued by their colleagues (p < 0.001) or by the director of the centre where they worked (p < 0.001). CONCLUSIONS: Based on the results of this study, Spanish music therapists show a low prevalence of burnout syndrome but a moderate-high predisposition to develop it. Music therapists with burnout syndrome are those who work longer hours and perform their job in palliative care setting. In general, music therapists have a high level of both intrinsic and extrinsic job satisfaction. The lowest level of job satisfaction was found in music therapists with trainee contracts and the highest in music therapists with senior positions.

Falls Prevention and Quality of Life Improvement by Square Stepping Exercise in People with Parkinson's Disease: Project Report.

Parkinson's disease (PD) is a chronic neurodegenerative disorder that affects physical, psychological, and social quality of life. Square Stepping Exercise (SSE) is an effective balance training program to prevent falls and to stimulate cognitive function in the elderly; however, no study has analyzed the effect of SSE in people with PD. The main objective is to investigate whether the application of SSE is safe, applicable, and can improve balance, and is effective in preventing falls, improving cognitive and psychological aspects and thus maximize quality of life in people with PD. Methods/Design: SSE will be performed three times per week for 8 weeks with an additional month follow-up after the intervention. Sixty people with PD will participate, randomly distributed into two groups: experimental group (SSE: n = 30) and control group (Usual care: n = 30). The primary measurements will be: (1) Applicability, (2) Safety, (3) Balance, and (4) Annual number of falls. Secondary measurements will be: (1) Sociodemographic information, (2) Physical condition, (3) Health-related quality of life, (4) Depressive symptoms, (5) Cognitive aspects, (6) Perceived functional social support, and (7) Anticipatory cognition.

Coping strategies and stress-induced natural killer cell redistribution in women with eating disorders.

BACKGROUND: Patients with eating disorders (ED) are very sensitive and responsive to psychosocial stress. Stress response includes changes in immune cell distribution and may be modulated by the capability to cope with stressors. Thus, the present study sought to analyze the association between coping strategies and immune response (natural killer [NK] cell redistribution following psychosocial stress) in patients with anorexia nervosa (AN) and bulimia nervosa (BN) and healthy controls (HC). METHOD: Twenty-four AN patients, 29 BN patients, and 58 HC were studied. A multidimensional assessment tool, the COPE Inventory, was used to assess coping strategies. The number of NK cells was quantified in peripheral blood before and after the application of the Trier Social Stress Test (TSST). Potentially mediating variables, such as weight status, severity of eating pathology, depression, anxiety, and impulsivity were controlled. RESULTS: The three groups differed in intensity and direction of cell redistribution: The TSST was followed in BN patients by a significant decrease in the number of NK cells, whereas HC displayed a moderate decrease and AN a clear increase. Specific correlations between coping strategies and NK cell mobilization were found, especially in BN patients (positive for "planning" and negative for "substance abuse"). CONCLUSION: Recognition and subsequent modification of the dysfunctional coping strategies used by patients with ED could contribute to improving their immune status, strengthening their resilience and increasing their ability to overcome the disease.

ANTECEDENTES: Los pacientes con trastornos de la conducta alimentaria (TCA) son muy sensibles y respondedores ante el estrés psicosocial. La respuesta al estrés incluye cambios en la distribución de las células inmunes y parece estar modulada por la capacidad de afrontamiento del individuo. En este contexto, el objetivo del presente estudio fue analizar la asociación entre estrategias de afrontamiento y redistribución tras el estrés de las células agresoras naturales (natural killer, NK) en pacientes de sexo femenino con anorexia nervosa (AN) y bulimia nervosa (BN), y controles sanos (CS). MÉTODO: Treinta y cuatro pacientes con AN, 29 pacientes con BN y 58 CS fueron estudiados. Para evaluar las estrategias de afrontamiento se utilizó un instrumento multidimensional, el Inventario COPE. El número de células NK en sangre periférica fue cuantificado antes y después de la aplicación del Trier Social Stress Test (TSST). Las posibles variables mediadoras, como el estado ponderal, la gravedad de la patología alimentaria, depresión, ansiedad e impulsividad fueron control. RESULTADOS: Los tres grupos difirieron en la intensidad y la dirección de la redistribución de células NK: el TSST fue seguido de una notable reducción en el número de células NK en las pacientes con BN, de una disminución moderada en las CS y de un claro incremento en las pacientes con AN. Se encontraron correlaciones específicas entre estrategias de afrontamiento y movilización de células NK, especialmente en las pacientes con BN (positiva para "planificación" y negativa para "abuso de sustancias"). CONCLUSIÓN: El reconocimiento y la modificación consiguiente de las estrategias de afrontamiento disfuncionales utilizadas por las pacientes con TCA pueden contribuir a mejorar su estado inmunológico, incrementando su resistencia y su capacidad para superar la enfermedad.

Papel de la depresión y la impulsividad en la psicopatología de la bulimia nerviosa / The role of depression and impulsivity in the psychopathology of bulimia nervosa

Introducción. El presente estudio trató de analizar el papel de la depresión y la impulsividad en la psicopatología de la bulimia nerviosa (BN). Materiales y métodos. Se examinó a 70 mujeres con un diagnóstico de bulimia nerviosa basado en la cuarta revisión del Manual diagnóstico y estadístico de los trastornos mentales (DSM-IV), subtipo purgativo, para los síntomas relacionados con el trastorno de la conducta alimentaria, insatisfacción corporal, síntomas afectivos, impulsividad y rasgos de personalidad. Para el análisis estadístico se utilizaron métodos de análisis factorial y de modelos de ecuaciones estructurales. Resultados. La BN se presentó como un proceso que incorporaba 5 dimensiones generales: a) episodios recurrentes de gran voracidad o «atracones» y conductas compensadoras; b) conducta alimentaria restrictiva; c) insatisfacción corporal; d) rasgos de personalidad disocial; y e) una agrupación (cluster) de características que se denominó «inestabilidad emocional». Las 5 dimensiones obtenidas pueden agruparse en 2 factores básicos: insatisfacción corporal/conducta alimentaria y rasgos de personalidad/psicopatología. El primero contiene los ítems clínicos utilizados para la definición de la BN como proceso clínico en el DSM-V y la Clasificación Internacional de las Enfermedades, y refleja la morfología y la gravedad de los síntomas relacionados con la conducta alimentaria. La segunda dimensión incluye una agrupación de síntomas (síntomas depresivos, impulsividad y rasgos límite de personalidad [borderline]), conducta autodestructiva y disocial) que podrían considerarse como la «base psicopatológica de la bulimia nerviosa» y pueden condicionar su curso y su pronóstico (AU)

Introduction. The study aimed to analyze the role of depression and impulsivity in the psychopathology of bulimia nervosa (BN). aterials and methods. Seventy female patients with DSM-IV BN, purging subtype, were assessed for eating-related symptoms, body dissatisfaction, affective symptoms, impulsivity, and personality traits. Factor analysis and structural equation modeling methods were used for statistical analysis. Results. BN appeared as a condition which incorporated 5 general dimensions: a) binge eating and compensatory behaviours; b) restrictive eating; c) body dissatisfaction; d) dissocial personality traits; and e) a cluster of features which was called «emotional instability» The 5 obtained dimensions can be grouped into 2 basic factors: body dissatisfaction/eating behaviour and personality traits/psychopathology. The first one contains the clinical items used for the definition of BN as a clinical condition in the DSM-V and the International Classification of Diseases 10, and reflects the morphology and the severity of the eating-related symptoms. The second dimension includes a cluster of symptoms (depressive symptoms, impulsivity, and borderline, self-defeating and dissocial personality traits) which could be regarded as the «psychopathological core» of BN and may be able to condition the course and the prognosis of BN (AU)

The role of depression and impulsivity in the psychopathology of bulimia nervosa.

INTRODUCTION: The study aimed to analyze the role of depression and impulsivity in the psychopathology of bulimia nervosa (BN). MATERIALS AND METHODS: Seventy female patients with DSM-IV BN, purging subtype, were assessed for eating-related symptoms, body dissatisfaction, affective symptoms, impulsivity, and personality traits. Factor analysis and structural equation modeling methods were used for statistical analysis. RESULTS: BN appeared as a condition which incorporated 5 general dimensions: a) binge eating and compensatory behaviours; b) restrictive eating; c) body dissatisfaction; d) dissocial personality traits; and e) a cluster of features which was called «emotional instability¼ The 5 obtained dimensions can be grouped into 2 basic factors: body dissatisfaction/eating behaviour and personality traits/psychopathology. The first one contains the clinical items used for the definition of BN as a clinical condition in the DSM-V and the International Classification of Diseases 10, and reflects the morphology and the severity of the eating-related symptoms. The second dimension includes a cluster of symptoms (depressive symptoms, impulsivity, and borderline, self-defeating and dissocial personality traits) which could be regarded as the «psychopathological core¼ of BN and may be able to condition the course and the prognosis of BN.